ABSTRACT
Aim: To investigate the association between tobacco smoking habits and severity and mortality of COVID-19 disease among ICU hospitalized patients. Material: Baseline sociodemographic, co-morbidities and clinical characteristics of 222 adult (70 women) COVID-19 hospitalized patients, aged 69+/-8yrs, mean ICU length of stay 35+/-12 days, were retrospectively collected and analyzed from 01/08/2020-01/08/2021. Also, information about caregivers' tobacco smoking behaviors were obtained. Result(s): 57 patients were current smokers (35+/-4 pack/yrs) and 61 ex-smokers(28+/-9pack/yrs). E-cigarette users were 18 patients (2 ex-smokers), dual users 22 (all current smokers). 37 continued to smoke up to hospital admission. Arterial hypertension (47/35) diabetes (44/24), betamuI>30 (22/34), coronary disease (40/22) and COPD (41/28) noted as main comorbidities in current smokers and ex-smokers. CT findings of pulmonary emphysema were detected in 31% of current and ex-smokers. 51% (113) of total patients died, aged 71+/-4 yrs, and ICU length of stay 40+/-15 days. Current smokers and ex-smokers were hospitalized in ICU for a longer period 29+/-7 days (p=0.001). APACHE II (48+/-8) and SOFA score (11+/-3) were higher in current smokers and ex-smokers (p=0.003). 53% of ICU patients had a family member that smoked, and 35% of them were willing to undergo a Tobacco Prevention and Cessation Program. 90% of current smokers after ICU discharge quitted smoking. Conclusion(s): Tobacco smoking is a serious comorbidity in ICU patients hospitalized for covid 19 disease, with both current smokers and ex-smokers reveal more severe rates of mortality and morbidity.
ABSTRACT
INTRODUCTION Telehealth for COVID-19 patients is still limited. We aimed to assess the clinical effects of a home-based tele-rehabilitation exercise program following hospital discharge during the first lockdown in Greece, April to July 2020. METHODS A pre-and post-intervention design was applied in two stages. Firstly, patients were instructed to use a specially designed for COVID-19, e-book during four tele-health sessions. Afterwards, a 2-month home-based program consisted of self-practice exercise and one-hour supervised tele-rehabilitation exercise sessions every 10 days, was delivered. At baseline and at the end of the program, participants were interviewed about their physical, psychological status and quality of life (QoL) during the post-hospitalization period. The IPAQ-Gr, the HADS and the SF-36 questionnaires were used, respectively, and the participants were functionally assessed via teleconferences, using the 60 sec Sit to Stand Test (60secSTS), the Short Physical Performance Battery (SPPB) and the 3 min Step Test (3MST). RESULTS Seventy-four patients, median age 52.5 (IQR: 43–61) years were included at the first stage. From those, only 22 patients, mean ± SD age 50.1 ± 13.2 years completed the 2-month exercise program. The training program was well tolerated by all 22 patients. The mean number of unsupervised exercise sessions was 18.4 ± 3.5. No adverse effects were observed either during initial and follow-up assessment via tele-communication or during home-exercise sessions. Training improved significantly (p<0.001) lower limb muscle performance [median (IQR) 60secSTS: 22 (20–26) to 31 (25–36)], anxiety [median (IQR) HADS: 9 (6–13) to 4.3 (3.2–9.6)], depression [median (IQR) HADS: 5 (3–8) to 1.8 (0.9–3.7)], QoL [mean ± SD SF-36pcs: 37.5 ± 10.3 to 52.1 ± 6, and mean ± SD SF-36mcs: 42.9 ± 11.6 to 45.5 ± 12.3]. CONCLUSIONS Tele-rehabilitation may be feasible and may improve physical and psychological status of COVID-19 patients after hospital discharge. © 2022 Kortianou E. et al.