Investigating patient-reported outcomes among COVID-19 survivors : a longitudinal cohort study

Background: Many Coronavirus Disease 2019 (COVID-19) survivors report long-term sequelae. However, few studies have measured patient-reported outcomes and compared them to those of patients who tested negative for severe acute respiratory syndrome coronavirus-2 (SARS-COV-2). This study compares the long-term physical and mental health outcomes of patients presenting to emergency departments who tested positive for SARS-COV-2 with those who tested negative. Methods: This study enrolled consecutive eligible patients presenting to emergency departments participating in the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) between March 1st 2020 and July 14th 2021. Patients tested for SARS-COV-2 were eligible. Consecutive SARS-COV-2 positive patients were consented for follow-up, and matched with test-negative controls from the same hospital and date. The outcome measures were the Veterans RAND physical health component score (PCS) and mental health component score (MCS). The PCS and MCS of propensity score matched patients were analyzed using linear mixed effects models. Risk factors for PCS and MCS were modelled using linear regression. Results: Our cohort included 1170 SARS-COV-2 positive patients and 3716 test-negative controls. Comparing the groups, the adjusted mean difference in PCS was 0.50 (95%CI: -0.36, 1.36) and -1.01 (95%CI: -1.91, -0.11) for MCS. A World Health Organization Ordinal Outcome Score of 6-7, representing severe SARS-COV-2 disease, was the strongest predictor of PCS (β=-7.4; 95%CI: -9.8, -5.1). Prior mental health illness was the strongest predictor of MCS (β=-5.4; 95%CI: -6.3, -4.5). Conclusion: The mean PCS was similar among SARS-COV-2 positive and negative participants tested under similar circumstances, while mean MCS was worse among SARS-COV-2 positive participants. The mental health sequelae of COVID-19 should be considered when developing long-term support programs for survivors.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat

Resource utilization and outcomes of 858 patients hospitalized primarily for COVID-19 using clinician decision, identified by the CDC algorithm or Massachusetts method.

Resource utilization and outcomes of 858 patients hospitalized primarily for COVID-19 using clinician decision, identified by the CDC algorithm or Massachusetts method.</p

Patient and presentation characteristics by admission status using clinician decision.

Patient and presentation characteristics by admission status using clinician decision.</p

Resource utilization and outcomes of 1,651 patients, by admission status and classification method.

Resource utilization and outcomes of 1,651 patients, by admission status and classification method.</p

Flow diagram of enrolled patients.

ED = emergency department; SARS-CoV-2 = Severe acute respiratory syndrome coronavirus 2.</p

Predefined drop-down menu of COVID-19 related diagnoses allocated to the hospitalized primarily for COVID-19 category.

Predefined drop-down menu of COVID-19 related diagnoses allocated to the hospitalized primarily for COVID-19 category.</p

Factors associated with ventilation, critical care admission or mortality among 1,651 SARS-CoV-2 positive patients, according to the CDC admission classification.

OR = odds ratio; ICU = intensive care unit; CI = confidence interval. a active malignant neoplasm, transplant recipient, moderate/severe liver disease. Hospital site was included as a fixed effect in this model. For simplicity, site estimates were excluded from the table. (DOCX)</p

Factors associated with ventilation, critical care admission or mortality among 1,651 SARS-CoV-2 positive patients, according to the Massachusetts admission classification.

OR = odds ratio; ICU = intensive care unit; CI = confidence interval. a active malignant neoplasm, transplant recipient, moderate/severe liver disease. Hospital site was included as a fixed effect in this model. For simplicity, site estimates were excluded from the table. (DOCX)</p