Purpose
To assess the association between acute disease severity and 1-year quality of life in patients discharged after hospitalisation due to coronavirus disease 2019 (COVID-19).
Methods
We conducted a prospective cohort study nested in 5 randomised clinical trials between March 2020 and March 2022 at 84 sites in Brazil. Adult post-hospitalisation COVID-19 patients were followed for 1 year. The primary outcome was the utility score of EuroQol five-dimension three-level (EQ-5D-3L). Secondary outcomes included all-cause mortality, major cardiovascular events, and new disabilities in instrumental activities of daily living. Adjusted generalised estimating equations were used to assess the association between outcomes and acute disease severity according to the highest level on a modified ordinal scale during hospital stay (2: no oxygen therapy; 3: oxygen by mask or nasal prongs; 4: high-flow nasal cannula oxygen therapy or non-invasive ventilation; 5: mechanical ventilation).
Results
1508 COVID-19 survivors were enrolled. Primary outcome data were available for 1156 participants. At 1 year, compared with severity score 2, severity score 5 was associated with lower EQ-5D-3L utility scores (0.7 vs 0.84; adjusted difference, − 0.1 [95% CI − 0.15 to − 0.06]); and worse results for all-cause mortality (7.9% vs 1.2%; adjusted difference, 7.1% [95% CI 2.5%–11.8%]), major cardiovascular events (5.6% vs 2.3%; adjusted difference, 2.6% [95% CI 0.6%–4.6%]), and new disabilities (40.4% vs 23.5%; adjusted difference, 15.5% [95% CI 8.5%–22.5]). Severity scores 3 and 4 did not differ consistently from score 2.
Conclusions
COVID-19 patients who needed mechanical ventilation during hospitalisation have lower 1-year quality of life than COVID-19 patients who did not need mechanical ventilation during hospitalisation.
Supplementary Information
The online version contains supplementary material available at 10.1007/s00134-022-06953-1.
Dengue is a viral disease transmitted by mosquitoes that has spread rapidly across all continents in recent years. There are four distinct but closely related serotypes of the virus that causes dengue (DENV-1, DENV-2, DENV-3, and DENV-4). The present study evaluated dengue virus (DENV) serotypes' temporal spreading and molecular evolution worldwide. Bayesian coalescent analyses with was performed to study viral evolution. The results demonstrated that the tMRCA of DENV-1 was 1884-11-15 in Southeast Asia, DENV-2 was 1723-01-29 in Europe, DENV-3 was 1921-04-12 in Southeast Asia, and DENV-4 was 1876-03-28 in Southeast Asia. The origin of the DENV was in Spain in 1682, later it was disseminated in Asia and Oceania in 1847. After this period, the virus presented dissemination in North America in 1890.In South America, it was rst disseminated to Ecuador in 1897 and then to Brazil in 1910. The dengue disease has had a signi cant impact on global health worldwide and the present study provides an overview of the molecular evolution of DENV serotypes.
Dengue is a viral disease transmitted by mosquitoes that has spread rapidly across all continents in recent years. There are four distinct but closely related serotypes of the virus that causes dengue (DENV-1, DENV-2, DENV-3, and DENV-4). The present study evaluated dengue virus (DENV) serotypes' temporal spreading and molecular evolution worldwide. Bayesian coalescent analyses with was performed to study viral evolution. The results demonstrated that the tMRCA of DENV-1 was 1884-11-15 in Southeast Asia, DENV-2 was 1723-01-29 in Europe, DENV-3 was 1921-04-12 in Southeast Asia, and DENV-4 was 1876-03-28 in Southeast Asia. The origin of the DENV was in Spain in 1682, later it was disseminated in Asia and Oceania in 1847. After this period, the virus presented dissemination in North America in 1890. In South America, it was first disseminated to Ecuador in 1897 and then to Brazil in 1910. The dengue disease has had a significant impact on global health worldwide and the present study provides an overview of the molecular evolution of DENV serotypes.
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