The health-related quality of life in patients with post-COVID-19 after hospitalization: a systematic review

ABSTRACT Symptoms in post-COVID-19 patients who require hospitalization can persist for months, significantly affecting their health-related quality of life (HRQoL). Thus, the present study aimed to discuss the main findings regarding HRQoL in post-COVID-19 patients who required hospitalization. An electronic search was performed in the MEDLINE, EMBASE, CINAHL, Web of Science, LILACS, and Scopus databases, without date and language restrictions, until July 2021. Twenty-four articles were included in the analysis. It seems that HRQoL partially improved soon after hospital discharge, although the negative impact on HRQoL may persist for months. The physical and mental aspects are affected because patients report pain, discomfort, anxiety, and depression. The HRQoL of COVID-19 infected patients was worse than that of uninfected patients. Additionally, HRQoL seemed worse in patients admitted to the intensive care unit than in those who remained in the ward. Improvements in HRQoL after hospital discharge are independent of imaging improvement, and there seems to be no association between HRQoL after hospital discharge and disease severity on hospital admission. Many factors have been identified as determinants of HRQoL, with women and advanced age being the most related to worse HRQOL, followed by the duration of invasive mechanical ventilation and the need for intensive care. Other factors included the presence and number of comorbidities, lower forced vital capacity, high body mass index, smoking history, undergraduate education, and unemployment. In conclusion, these findings may aid in clinical management and should be considered in the aftercare of patients.

A vibração torácica na fisioterapia respiratória de recém-nascidos causa dor / Does chest vibration during respiratory physiotherapy in neonates cause pain

OBJETIVO: Avaliar a dor em recém-nascidos pré-termo (RNPT) submetidos à fisioterapia respiratória em Unidade de Terapia Intensiva Neonatal. MÉTODOS: Estudo transversal realizado com recém-nascidos prematuros, com indicação de fisioterapia respiratória, em respiração espontânea. Foi aplicada uma técnica de vibração torácica com a mão do terapeuta realizando pequenas oscilações sobre o tórax do paciente e feita a avaliação da frequência cardíaca (FC), frequência respiratória (FR), saturação de pulso de oxigênio (SpO2) e do Sistema de Codificação da Atividade Facial Neonatal (NFCS) para a avaliação da dor antes, durante, imediatamente após (pós-i) e 30 minutos após (pós-30) a vibração no tórax do paciente. Utilizou-se a análise de variância para medidas repetidas para comparação entre as fases, considerando-se significante p<0,05. RESULTADOS: Foram avaliados 13 RNPT, com média de idade gestacional 32,5±2,0 semanas e peso de nascimento 1830±442g. Não foi observada pontuação de dor durante toda a avaliação: pré: 0,5±1,7; durante: 1,5±1,4; pós-i: 1,0±1,3; pós-30: 0±0,3, porém houve diferença estatisticamente significativa entre a fase pós-i e pós-30 na escala NFCS (p<0,05). A FC variou de 120 a 150bpm, a SpO2 permaneceu acima de 95 por cento, e a FR entre 40 e 62rpm, sem diferenças entre os períodos. CONCLUSÕES: Neste grupo de pacientes prematuros internados em UTI neonatal e submetidos à realização de fisioterapia respiratória pela técnica de vibração torácica, não foram observadas alterações fisiológicas e comportamentais de dor.

OBJECTIVE: To observe pain score during chest physiotherapy (CP) in preterm newborns (PTNB) assisted in a Neonatal Intensive Care Unit. METHODS: A cross-sectional study was carried out with PTNB with spontaneous breathing that needed respiratory physiotherapy. A vibration technique was employed, with the hand of the therapist applying oscillations on the patients' thorax. The following variables were assessed: heart rate (HR), respiratory rate (RR) and oxygen saturation (O2Sat), as well as the Neonatal Facial Coding System (NFCS) to analyze pain before (pre), during, just after and 30 minutes after the thoracic vibration technique. Repeated measures analysis of variance was applied to analyze the protocol phases, being significant p<0.05. RESULTS: Thirteen PTNB were assessed. The mean gestational age was 32.5±2.0 weeks, and the birth weight was 1830±442g. No pain was observed during the evaluation: "pre": 0.5±1.7; "during": 1.5±1.4; "just after": 1.0±1.3; "30 min after": 0±0.3, but there was difference in the NFCS scores between the periods "just after" and "30 minutes after" (p<0.05). The HR varied between 120 and 150bpm, O2Sat levels remained over 95 percent, and RR oscillated from 40 to 62mpm, without differences between periods. CONCLUSIONS: Preterm patients spontaneously breathing and submitted to respiratory physiotherapy by thoracic vibration, no evidence of physiological or behavioral pain indicators were observed.