Long Term Health and Economic Impacts Faced By COVID-19 Patients After Discharge from Inpatient Health Care Facilities Restricted; Files Only

Murali, Mahitha (Spring 2021)

Permanent URL: https://etd.library.emory.edu/concern/etds/br86b496w?locale=en
Published

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has resulted in long-term symptoms experienced by patients several months post discharge from their initial hospitalization for treatment. The prevalence and risk factors for persistent symptoms and patients' costs of care are not fully known for patients who experienced COVID-related inpatient care. The goal of the research is to gather new information to improve long-term patient care for patients who have had a COVID-19 diagnosis and have been admitted to an inpatient facility in Atlanta, Georgia 6 months ago, and to understand the long-term consequences faced by these patients.

Methods: Participants discharged from Emory University Hospitals for COVID-19 were contacted to complete a self-administered survey about long-term symptoms, hospitalization, costs of care, and their quality of life >6months post discharge. Bivariate and multivariable analyses were performed to evaluate associations between participant demographics and persistent symptoms.

Results: Two hundred and ten participants provided responses to the survey, of which 91 patients (36.99%) had reported experiencing at least 1 persistent symptom, a median of 10 months post-discharge, and 155 individuals (63.01%) did not have ongoing symptoms. The median age was 54 (range 21-95), and 110 (52.38%) participants were Black. The median length of stay was 5 days (mean=9.86, range=0,100) for their hospitalization. When looking at overall health at present compared to before covid, 111 participants (46.44%) reported feeling about the same, whereas 27.2% mentioned that their thinking and memory are worse after COVID-19, which did not vary by presence of "long" COVID-19. Common symptoms associated with reports of worse physical health included fatigue (n= 48, 53.33%) and shortness of breath with activity (n=46, 51.1%). Following those symptoms, joint pain (n= 32, 35.56%), muscle aches (n= 29, 32.22%), weakness (n= 28, 31.11%), and back pain (n= 23, 25.56%) were most prevalent in the study population. 

Conclusion and Public Health Implications: In this cohort study of COVID-19–related long-term symptoms, physical and psychosocial symptoms highlighted the impacts on complete recovery many months after diagnosis. Early identification of these symptoms could help prepare patients for long-term symptoms several months post discharge after being hospitalized for COVID-19.

Table of Contents

TABLE OF CONTENTS

1.    CHAPTER 1: INTRODUCTION  1

2.    CHAPTER 2: LITERATURE REVIEW   3

A.  COVID-19: Background   4

B.   Covid Implications 5

C.   Long Term Symptoms  6

D.  Post discharge Implications  7

E.   Psychosocial Impacts 8

F.   Economic Impacts  9

3.    CHAPTER 3: RESEARCH MANUSCRIPT 11          

A.  Abstract 11

B.   Introduction 14

·     Specific Aims  15          

C.   Methods 16

·     Electronic Medical Records (EMR) Data  16

·     Eligibility Criteria and Study Population 16

·     Informed Consent  17

·     Survey Methods  17

·     Data Collection 18

·     Data Analysis   18          

D.  Results    20

·     Descriptive Variables  20

·     Long-Term/Persistent Symptoms 20

·     Hospitalizations 21

·     Cost of Care and Economic Impact  21          

E.   Discussion  23

·     Limitations   25          

F.   Appendix: Tables 1- 5 28

·     Table 1: Characteristics of COVID-19 positive patients seen at Emory Hospital 28

·     Table 2: Symptoms in confirmed COVID-19 encounters > 6 months post discharge 29

·     Table 3: Bivariate analyses and multivariate logistic regression showing odds ratio for persistent symptoms 30

·     Table 4: Other Survey Variables 32

·     Table 5: Quality of Life Variables 34        

4.    CHAPTER 4: CONCLUSION AND RECOMMENDATIONS  35

A.  Conclusion     35

B.   Recommendations  35

C.   Public Health Implications     37

5. REFERENCES  40    

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