ABSTRACT
BACKGROUND: There are few reports of new functional impairment following critical illness from COVID-19. We aimed to describe the incidence of death or new disability, functional impairment and changes in health-related quality of life of patients after COVID-19 critical illness at 6 months. METHODS: In a nationally representative, multicenter, prospective cohort study of COVID-19 critical illness, we determined the prevalence of death or new disability at 6 months, the primary outcome. We measured mortality, new disability and return to work with changes in the World Health Organization Disability Assessment Schedule 2.0 12L (WHODAS) and health status with the EQ5D-5LTM. RESULTS: Of 274 eligible patients, 212 were enrolled from 30 hospitals. The median age was 61 (51-70) years, and 124 (58.5%) patients were male. At 6 months, 43/160 (26.9%) patients died and 42/108 (38.9%) responding survivors reported new disability. Compared to pre-illness, the WHODAS percentage score worsened (mean difference (MD), 10.40% [95% CI 7.06-13.77]; p < 0.001). Thirteen (11.4%) survivors had not returned to work due to poor health. There was a decrease in the EQ-5D-5LTM utility score (MD, - 0.19 [- 0.28 to - 0.10]; p < 0.001). At 6 months, 82 of 115 (71.3%) patients reported persistent symptoms. The independent predictors of death or new disability were higher severity of illness and increased frailty. CONCLUSIONS: At six months after COVID-19 critical illness, death and new disability was substantial. Over a third of survivors had new disability, which was widespread across all areas of functioning. Clinical trial registration NCT04401254 May 26, 2020.
Subject(s)
COVID-19/epidemiology , Critical Illness/epidemiology , Disabled Persons , Recovery of Function/physiology , Return to Work/trends , Aged , Aged, 80 and over , Australia/epidemiology , COVID-19/diagnosis , COVID-19/therapy , Cohort Studies , Critical Illness/therapy , Female , Follow-Up Studies , Health Status , Humans , Male , Middle Aged , Mortality/trends , Prospective Studies , Time Factors , Treatment OutcomeABSTRACT
Background: The COVID-19 epidemic not only brings challenges to the health of people all over the world, but also impacts the global economy, and employment. Therefore, promoting industry and business to resume work safely has become an important step to be taken by all countries in overcoming the economic recession and restarting growth. Objective: This study aims to elaborate on epidemic prevention measures a Chinese company (Company C) took during work resumption. Methods: In this study, we used a case study design, with field research method applied to data collection and analysis. Results: It has been identified that Company C took a range of measures to prevent the outbreak of COVID-19 inside the company, which involve work resumption preparation (information survey, health training, work resumption plan, epidemic prevention plan), facilities management, materials management, employee activity management, and so on. Conclusion: When the COVID-19 epidemic was initially controlled in February, the Chinese government allowed enterprises to resume work voluntarily, which did not bring about a rebound in the epidemic. One important reason is that Chinese enterprises have taken multiple measures to prevent the spread of the COVID-19 virus. Company C's practices could shed some light on how companies in Western countries resume their work during the COVID-19 pandemic.
Subject(s)
COVID-19 , Organizational Case Studies , Return to Work/trends , Teaching , Workplace/organization & administration , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Economic Recession , Humans , SARS-CoV-2/isolation & purification , Surveys and QuestionnairesSubject(s)
COVID-19 , Hospitals, Psychiatric , Infection Control , Mental Disorders , Stress, Psychological , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Child , China/epidemiology , Comorbidity , Forecasting , Hospitals, Psychiatric/organization & administration , Hospitals, Psychiatric/trends , Humans , Infection Control/methods , Infection Control/organization & administration , Mental Disorders/epidemiology , Mental Disorders/therapy , Organizational Innovation , Psychiatric Rehabilitation/trends , Return to Work/psychology , Return to Work/trends , SARS-CoV-2 , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/psychologyABSTRACT
This paper seeks to determine which workers affected by lockdown measures can return to work when a government decides to apply lockdown exit strategies. This system, which we call Sequential Selective Multidimensional Decision (SSMD), involves deciding sequentially, by geographical areas, sectors of activity, age groups and immunity, which workers can return to work at a given time according to the epidemiological criteria of the country as well as that of a group of reference countries, used as a benchmark, that have suffered a lower level of lockdown de-escalation strategies. We apply SSMD to Spain, based on affiliation to the Social Security system prior to the COVID-19 pandemic, and conclude that 98.37% of the population could be affected. The proposed system makes it possible to accurately identify the target population for serological IgG antibody tests in the work field, as well as those affected by special income replacement measures due to lockdown being maintained over a longer period.