Evaluación de la salud sexual, mental y sueño en hombres chilenos posterior a infección por SARS-CoV-2 / Sexual, physical, mental and sleep sequelae four months after SARS-CoV-2 disease

BACKGROUND: Long term sequelae can be observed after SARS-CoV2. AIM: To describe the sexual, physical, mental and sleep sequelae four months after SARS-CoV2 diagnosis. PATIENTS AND METHODS: Patients recovering from SARS-CoV2 with different degrees of disease severity were consecutively included and separated in two study groups, namely Group 1 including patients that had an acute respiratory distress syndrome (ARDS) and Group 2 including those with mild or moderate COVID-19. Handgrip strength, respiratory polygraphy (RP), Quality of life using the SF-12 questionnaire, and the international index of erectile (IIEF-5) function were assessed. RESULTS: Twenty patients who had ARDS, and 10 without ARDS were included. Erectile dysfunction was observed in 77 and 10% of patients with and without ARDS, respectively (p < 0.01). The figures for sleep obstructive apnea were 82 and 40% respectively (p = 0.02) and for the physical domain SF-12 score were 39.2 and 47.9 points respectively (p = 0.01). No differences in muscle strength were observed. After a multivariable analysis, previous ARDS due to COVID-19 was independently associated with erectile dysfunction, with an odds ratio of 30.6 (95% confidence intervals, 3.08300.3, p = 0.003). CONCLUSIONS: Among men with ARDS due to COVID-19, the prevalence of erectile dysfunction was high and independently associated with a severe disease four months after discharge.

Características y desenlace clínico de 30 pacientes con hemopatías malignas y COVID-19 en un hospital público regional / Features of COVID-19 infection among patients with hematological malignancies

BACKGROUND: COVID-19 infection can be especially severe in certain risk populations such as patients with hematologic malignancies. Aim: To describe the characteristics and clinical outcomes of a population of patients with hematologic malignancies and COVID-19. MATERIAL AND METHODS: Review of medical records of patients with COVID-19 and hematologic malignancies, treated in Hematology Service of a regional hospital in Chile, between April 1 and October 30, 2020. Demographic characteristics, chronic comorbidities and clinical characteristics related to the underlying disease and COVID-19 infection were recorded. Results: Thirty adults aged 17 to 73 years (67% men) with COVID-19 confirmed by RT-PCR, were evaluated. Forty percent had comorbidities, mainly hypertension (30%), obesity (27%) and diabetes (10%). Two thirds of cases came from a nosocomial outbreak and 77% were symptomatic. Half of the cases had mild disease and 20% required mechanical ventilation. Five patients (17%) died from COVID 19. Female sex, the presence of comorbidities and obesity were more common among deceased patients. Only 1 of 5 deceased patients were in complete remission. No differences were found in the mean survival according to requirement for intubation or the presence of complete remission. CONCLUSIONS: This population with hematologic malignancies and COVID-19 had special characteristics leading to a greater fatality rate which, in this series, does not increase with the use of mechanical ventilation.

Sleep health and the circadian rest-activity pattern four months after COVID-19 / Saúde do sono e o padrão circadiano de atividade e repouso quatro meses depois da COVID-19

ABSTRACT Objective: To describe the prevalence and severity of sleep disorders and circadian alterations in COVID-19 patients four months after the acute phase of the disease. Methods: This was a cross-sectional observational prospective study of patients with mild COVID-19, moderate COVID-19 (requiring hospitalization but no mechanical ventilation), or severe COVID-19 (with ARDS) four months after the acute phase of the disease. All patients underwent a home sleep apnea test and seven-day wrist actigraphy, as well as completing questionnaires to assess sleep quality and mental health. Differences among the three groups of patients were evaluated by ANOVA and the chi-square test. Results: A total of 60 patients were included in the study. Of those, 17 were in the mild COVID-19 group, 18 were in the moderate COVID-19 group, and 25 were in the severe COVID-19 group. Sleep quality, as assessed by satisfaction, alertness, timing, efficiency, and duration scale scores, was found to be impaired in all three groups, which also had a high prevalence of unhealthy sleep, as assessed by the Pittsburgh Sleep Quality Index. The prevalence of insomnia was increased in all three groups, as assessed by the Insomnia Severity Index. The home sleep apnea test showed that the overall prevalence of obstructive sleep apnea was 60%, and seven-day wrist actigraphy showed that total sleep time was < 7 h in all three groups. Changes in quality of life and in the circadian rest-activity pattern were observed in all three groups. Conclusions: Sleep-related symptoms, changes in the circadian rest-activity pattern, and impaired mental health appear to be common in COVID-19 patients four months after the acute phase of the disease, severe COVID-19 being associated with a higher prevalence of obstructive sleep apnea.

RESUMO Objetivo: Descrever a prevalência e gravidade de transtornos do sono e alterações circadianas em pacientes com COVID-19 quatro meses depois da fase aguda da doença. Métodos: Estudo prospectivo observacional transversal com pacientes com COVID-19 leve, moderada (com necessidade de hospitalização, mas não de ventilação mecânica) ou grave (com SDRA) quatro meses depois da fase aguda da doença. Todos os pacientes foram submetidos a teste domiciliar de apneia do sono e actigrafia de sete dias, além de terem preenchido questionários para avaliar a qualidade do sono e a saúde mental. As diferenças entre os três grupos foram avaliadas por meio de ANOVA e teste do qui-quadrado. Resultados: Foram incluídos no estudo 60 pacientes. Destes, 17 eram do grupo COVID-19 leve, 18 do grupo COVID-19 moderada e 25 do grupo COVID-19 grave. A qualidade do sono, avaliada pela pontuação na escala satisfaction, alertness, timing, efficiency, and duration, foi prejudicada nos três grupos, que também apresentaram alta prevalência de sono não saudável, pelo Índice de Qualidade do Sono de Pittsburgh. A prevalência de insônia, avaliada pelo Insomnia Severity Index, foi elevada nos três grupos. O teste domiciliar de apneia do sono mostrou que a prevalência geral de apneia obstrutiva do sono foi de 60%, e a actigrafia de sete dias mostrou que o tempo total de sono foi < 7 h nos três grupos. Alterações da qualidade de vida e do padrão circadiano de atividade e repouso foram observadas nos três grupos. Conclusões: Sintomas relacionados ao sono, alterações do padrão circadiano de atividade e repouso e comprometimento da saúde mental parecem ser comuns em pacientes com COVID-19 quatro meses depois da fase aguda da doença, sendo a COVID-19 grave associada a uma maior prevalência de apneia obstrutiva do sono.