Poor-sleep is associated with slow recovery from lymphopenia and an increased need for ICU care in hospitalized patients with COVID-19: A retrospective cohort study

Zhang, Jiancheng; Xu, Dong Roman; Xie, Bing; Zhang, Yujing; Huang, Haiyan; Li, Hongmei; Hua-qi, Chen; Sun, Yunpeng; Shang, You; Hashimoto, Kenji; Yuan, Shiying

doi:10.1016/j.bbi.2020.05.075

Cited by 91 publications

(101 citation statements)

References 42 publications

(36 reference statements)

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“…Systematic search as depicted in Figure 1A yield 125 eligible publications, including 25,252 participants 18–141 . Articles were published in 11 countries, predominated by China (101 studies; Figure 1B).…”

Section: Resultsmentioning

confidence: 99%

Gastroenterology manifestations and COVID‐19 outcomes: A meta‐analysis of 25,252 cohorts among the first and second waves

Elshazli

Kline

Elgaml

et al. 2021

Journal of Medical Virology

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A meta-analysis was performed to identify patients with coronavirus disease 2019 presenting with gastrointestinal (GI) symptoms during the first and second pandemic waves and investigate their association with the disease outcomes. A systematic search in PubMed, Scopus, Web of Science, ScienceDirect, and EMBASE was performed up to July 25, 2020. The pooled prevalence of the GI presentations was estimated using the random-effects model. Pairwise comparison for the outcomes was performed according to the GI manifestations' presentation and the pandemic wave of infection. Data were reported as relative risk (RR), or odds ratio and 95% confidence interval. Of 125 articles with 25,252 patients, 20.3% presented with GI manifestations. Anorexia (19.9%), dysgeusia/ageusia (15.4%), diarrhea (13.2%), nausea (10.3%), and hematemesis (9.1%) were the most common. About 26.7% had confirmed positive fecal RNA, with persistent viral shedding for an average time of 19.2 days before being negative. Patients presenting with GI symptoms on admission showed a higher risk of complications, including acute respiratory distress syndrome (RR = 8.16), acute cardiac injury (RR = 5.36), and acute kidney injury (RR = 5.52), intensive care unit (ICU) admission (RR = 2.56), and mortality (RR = 2.01). Although not reach significant levels, subgroup-analysis revealed that affected cohorts in the first wave had a higher risk of being hospitalized, ventilated, ICU admitted, and expired. This meta-analysis suggests an association between GI symptoms in COVID-19 patients and unfavorable outcomes. The analysis also showed improved overall outcomes for COVID-19 patients during the second wave compared to the first wave of the outbreak.

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Section: Resultsmentioning

confidence: 99%

Gastroenterology manifestations and COVID‐19 outcomes: A meta‐analysis of 25,252 cohorts among the first and second waves

Elshazli

Kline

Elgaml

et al. 2021

Journal of Medical Virology

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“…Poor sleep quality has been observed in people with COVID‐19. Among hospitalized patients in intensive care wards of the Wuhan Union Hospital, COVID‐19 patients with poor sleep quality compared to those with better sleep quality had lower recovery rates, poorer immune system functioning and longer hospital stays, negatively impacting their HRQoL (Zhang et al., 2020). Among patients who had recovered from COVID‐19 and were followed for 8 weeks after discharge, more than 85% had sleep problems including changes in subjective sleep quality, sleep latency, sleep duration, and daytime function.…”

Section: Discussionmentioning

confidence: 99%

A mediating role for mental health in associations between COVID‐19‐related self‐stigma, PTSD, quality of life, and insomnia among patients recovered from COVID‐19

et al. 2021

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Introduction Patients with COVID‐19 often suffer from psychological problems such as post‐traumatic stress disorder (PTSD) and self‐stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self‐stigmatization and PTSD to quality of life and sleep. Methods Using a cross‐sectional design, 844 people who had recovered from COVID‐19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self‐stigma and PTSD as independent factors and quality of life and insomnia as dependent variables. Results Mental health, COVID‐19‐related self‐stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID‐19‐related self‐stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID‐19‐related self‐stigma, PTSD, and insomnia and positive associations with quality of life. Conclusion Mental health may mediate effects of COVID‐19‐related self‐stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID‐19 may include efforts to reduce negative effects of PTSD and COVID‐19‐related self‐stigma on quality of life and insomnia.

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“…COVID-19 patients frequently exhibit sleep impairment ( 15 ), perhaps because of isolation (the absence of a family member), physical discomfort or a psychological factor (fear, anxiety, helplessness and/or depression) ( 14 ). Poor sleep quality in COVID-19 patients with lymphopenia is associated with slow recovery and an increased need for intensive care unit (ICU) care ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Relationship between sleep quality and the psychological status of patients hospitalised with COVID-19

Akıncı

Başar

2021

Sleep Medicine

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Poor-sleep is associated with slow recovery from lymphopenia and an increased need for ICU care in hospitalized patients with COVID-19: A retrospective cohort study

Cited by 91 publications

References 42 publications

Gastroenterology manifestations and COVID‐19 outcomes: A meta‐analysis of 25,252 cohorts among the first and second waves

Gastroenterology manifestations and COVID‐19 outcomes: A meta‐analysis of 25,252 cohorts among the first and second waves

A mediating role for mental health in associations between COVID‐19‐related self‐stigma, PTSD, quality of life, and insomnia among patients recovered from COVID‐19

Relationship between sleep quality and the psychological status of patients hospitalised with COVID-19

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