Impacto en la calidad de vida del paciente crítico afectado por Covid-19

Abstract

INTRODUCCIÓN Tras la fase aguda de la enfermedad por COVID-19 se han objetivado síntomas prolongados que afectan negativamente la calidad de vida. OBJETIVO Identificar los factores que afectan a la calidad de vida del paciente crítico diagnosticado de COVID-19 al año de alta de una Unidad de Cuidados Intensivos. MATERIAL Y MÉTODOS Estudio observacional, transversal y ambispectivo realizado en la Unidad de Reanimación del Consorcio Hospital General Universitario de Valencia a partir de una muestra (n = 122) pacientes ingresados desde marzo de 2020 a marzo de 2021.Los datos se recogieron mediante un cuestionario online autoadministrado. RESULTADOS La dimensión “Salud general” inadecuada se explicó con un valor (R2 = 0,682; IC = 95%) por la combinación de mayores estancias en la Unidad de Cuidados Intensivos (OR = 1,06; p = 0,022), estima social (OR = 0,011 p = 0,028), ansiedad y mialgias [(OR = 0,620; p < 0,001) (OR = 0,182; p = 0,047)] junto con alteraciones psiquiátricas y respiratorias [(OR = 0,227; p = 0,014) (OR = 0,293; p = 0,046)]. El “Rol físico” se vio alterado por la presencia conjunta mialgias alteraciones psiquiátricas, estigma social y depresión [R2 = 0,609; (OR = 0,101; p = 0,041) (OR = 0,258; p = 0,029) (OR = 0,902; p = 0,002) (OR = 0,733; p = 0,008)]; el “Bienestar emocional” se afectó por la presencia de mayor gravedad, depresión, mialgias y alteraciones psiquiátricas [R2 = 0,550; (OR = 1,054; p = 0,033) (OR = 0,670; p < 0,001) (OR = 0,229; p = 0,044) (OR = 0,131; p < 0,001)]. CONCLUSIONES: La combinación de secuelas físicas, psicológicas; así como mayor discriminación social y menor apoyo familiar determinaron cambios negativos en la calidad de vida, persistiendo al año del alta.

ABSTRACT BACKGROUND After the acute phase of the COVID-19 disease, prolonged symptoms that negatively affect the quality of life have been observed. AIMS To identify the factors that affect the quality of life of the critically ill patient diagnosed with COVID-19 one year after the discharge from an Intensive Care Unit. METHODS Observational, cross-sectional and ambispective study carried out in the Resuscitation Unit of the General University Hospital of Valencia Consortium with a sample (n = 122) patients admitted from March 2020 to March 2021. Deceased patients and those diagnosed with cognitive dysfunction were excluded. Data were collected using a self-administered online questionnaire. Mann-Whitney U, Kruskal- Wallis, Chi-square tests and binary logistic regression analysis were applied. A level of statistical significance p ≤ 0.05 was accepted. RESULTS The inadequate “General Health” dimension was explained with a value (R2 = 0.682; CI = 95%) by the combination of length Intensive Care Unit stay (OR = 1.06; p = 0.022), social esteem (OR = 0.011; p = 0.028), anxiety and myalgia [(OR = 0.620; p < 0.001) (OR = 0.182; p = 0.047)] together with psychiatric and respiratory disorders [(OR = 0.227; p = 0.014) (OR = 0.293 ;p = 0.046)]. The “Physical Role” got worse by the joint presence of myalgia, psychiatric disorders, social stigma and depression [R2 = 0.609; (OR = 0.101; p = 0.041) (OR = 0.258; p = 0.029) (OR = 0.902; p = 0.002) (OR = 0.733; p = 0.008)]; “Emotional well-being” was affected by the presence of greater severity, depression, myalgia, and psychiatric disorders [R2 = 0.550; (OR = 1.054; p = 0.033) (OR = 0.670; p < 0.001) (OR = 0.229; p = 0.044) (OR = 0.131; p < 0.001)]. CONCLUSIONS The combination of physical, psychological sequelae; as well as greater social discrimination and less family support determined negative changes in the quality of life, persisting one year after discharge.