TY - JOUR
T1 - The impact of pulmonary embolism on health outcomes of COVID-19 at 3 months after hospitalization
AU - Visser, Chantal
AU - Berentschot, Julia C.
AU - de Jong, Cindy M. M.
AU - Antoni, M. Louisa
AU - Bek, L. Martine
AU - van den Berg-Emons, Rita J. G.
AU - van den Borst, Bram
AU - ten Cate, Hugo
AU - ten Cate-Hoek, Arina J.
AU - Braeken, Dionne C. W.
AU - Geelhoed, J. J. Miranda
AU - Heijenbrok-Kal, Majanka H.
AU - van Kuijk, Sander M. J.
AU - Kroft, Lucia J. M.
AU - Leentjens, Jenneke
AU - Roukens, Anna H. E.
AU - Cannegieter, Suzanne C.
AU - Klok, Frederikus A.
AU - Kruip, Marieke J. H. A.
AU - Hellemons, Merel E.
AU - Dutch COVID & Thrombosis Coalition
PY - 2024/10/1
Y1 - 2024/10/1
N2 - Background: COVID-19 patients frequently experience pulmonary embolism (PE), but its long-term consequences remain uncertain. Objectives: To assess the impact of PE in COVID-19 patients on health outcomes at 3 months after hospitalization. Methods: In this multicenter cross-sectional study, we aggregated data from existing databases to evaluate the impact of PE on health outcomes at 3 months after hospitalization. We assessed 1) questionnaires on health-related quality of life (5-level EuroQol 5-dimensional questionnaire [EQ-5D-5L] questionnaire), anxiety, depression, cognitive failure, and posttraumatic stress disorder; 2) pulmonary function tests (diffusing capacity of the lungs for carbon monoxide [DLCO] and spirometry); and 3) radiological abnormalities. We developed 3 models to assess the association between PE and the EQ-5D-5L index and the percentage of predicted DLCO (DLCO%): a crude model (model 1), adjusted for age, sex, and presence of comorbidities (model 2), and model 2 additionally adjusted for intensive care unit admission (model 3). Results: We included 465 patients who had been hospitalized for COVID-19, of whom 102 (21.9%) had developed a PE during admission. Patients with PE had poorer EQ-5D- 5L index values, more impairment in pulmonary functions, and more frequent radio- logical abnormalities than patients without PE. Symptoms of anxiety, depression, cognitive failure, and posttraumatic stress disorder did not differ between the 2 groups. In model 2, PE was associated with lower EQ-5D-5L index and lower DLCO%. After additionally adjusting for intensive care unit admission, the association between PE and lower EQ-5D-5L index (mean difference = -0.069, [95% CI, -0.12 to -0.017]) remained but not between PE and DLCO%. Conclusion: Our findings suggest that PE in COVID-19 patients is associated with reduced health-related quality of life at 3 months after hospitalization. While PE may be a marker of COVID-19 severity, its presence during hospitalization could indicate potential long-term health issues, which may be considered during follow-up care.
AB - Background: COVID-19 patients frequently experience pulmonary embolism (PE), but its long-term consequences remain uncertain. Objectives: To assess the impact of PE in COVID-19 patients on health outcomes at 3 months after hospitalization. Methods: In this multicenter cross-sectional study, we aggregated data from existing databases to evaluate the impact of PE on health outcomes at 3 months after hospitalization. We assessed 1) questionnaires on health-related quality of life (5-level EuroQol 5-dimensional questionnaire [EQ-5D-5L] questionnaire), anxiety, depression, cognitive failure, and posttraumatic stress disorder; 2) pulmonary function tests (diffusing capacity of the lungs for carbon monoxide [DLCO] and spirometry); and 3) radiological abnormalities. We developed 3 models to assess the association between PE and the EQ-5D-5L index and the percentage of predicted DLCO (DLCO%): a crude model (model 1), adjusted for age, sex, and presence of comorbidities (model 2), and model 2 additionally adjusted for intensive care unit admission (model 3). Results: We included 465 patients who had been hospitalized for COVID-19, of whom 102 (21.9%) had developed a PE during admission. Patients with PE had poorer EQ-5D- 5L index values, more impairment in pulmonary functions, and more frequent radio- logical abnormalities than patients without PE. Symptoms of anxiety, depression, cognitive failure, and posttraumatic stress disorder did not differ between the 2 groups. In model 2, PE was associated with lower EQ-5D-5L index and lower DLCO%. After additionally adjusting for intensive care unit admission, the association between PE and lower EQ-5D-5L index (mean difference = -0.069, [95% CI, -0.12 to -0.017]) remained but not between PE and DLCO%. Conclusion: Our findings suggest that PE in COVID-19 patients is associated with reduced health-related quality of life at 3 months after hospitalization. While PE may be a marker of COVID-19 severity, its presence during hospitalization could indicate potential long-term health issues, which may be considered during follow-up care.
KW - COVID-19
KW - patient reported outcome measures
KW - pulmonary embolism
KW - quality of life
KW - respiratory
KW - function tests
KW - QUALITY-OF-LIFE
KW - RISK-FACTORS
KW - PREVALENCE
KW - SURVIVORS
KW - CAPACITY
U2 - 10.1016/j.rpth.2024.102573
DO - 10.1016/j.rpth.2024.102573
M3 - Article
SN - 2475-0379
VL - 8
JO - Research and practice in thrombosis and haemostasis
JF - Research and practice in thrombosis and haemostasis
IS - 7
M1 - e102573
ER -