RESUMEN
Background: TheWorld Health Organization declared the outbreak of coronavirus 2 (COVID-19) as a pandemic on March 11, 2020. This led to abundant research to understand nutrition support practices during these unprecedented times. The need for rapid response to a patient's clinical needs, however, left a gap in understanding of the impact the pandemic had on the quality of life (QOL) of patients receiving home parenteral nutrition (HPN). As HPN patients are already vulnerable to having lower QOL scores than the general population, this warrants further exploration. Understanding the HPN patient experience in the setting of the COVID-19 pandemic expands our knowledge so that we can maximize care and support for our patients, resulting in improved patient-reported outcomes. The objective of this study was to determine if there was an association between the COVID-19 pandemic and QOL measurements in patients receiving HPN. Method(s): Inclusion criteria included adult and pediatric patients enrolled in the Total Parenteral Nutrition at Home (HEALTH) registry who completed Short Forms 36 (SF-36) Quality of Life surveys. Data were retrospectively collected from SF-36 surveys and compared between three 12-month time periods: year 1 (March 1, 2019 to February 29, 2020);year 2 (March 1, 2020 to February 28, 2021);and year 3 (March 1, 2021 to February 28, 2022). The primary outcome measure was the difference in mean QOL scores between the 3 time periods for the 8 domains and 2 summary scores. A P value <0.05 was considered statistically significant. The secondary outcome measure was the number of hospitalizations, including length of stay and reason for admission. Result(s): A total of 348 standardized SF-36 surveys from patients across 31 states were included in this study. Clinical and demographic characteristics of the patients are provided in Table 1. QOL measurements for 8 domains and 2 summary scores are provided in Table 2. Six of eight domains and two summary scores were highest during year 1 (pre-COVID pandemic) with a subsequent decrease in year 2 and a slight improvement in year 3. There were no statistically significant differences in QOL scores between any of the three time periods. Role-emotional scores decreased while general health scores improved year over year although again, neither change was statistically significant. Only two hospital admissions were reported as COVID-19 related during year 2. The most prevalent reasons for admission in year 2 and 3 were infection, unrelated to COVID-19 (Table 2). Conclusion(s): SF-36 survey scores in six of the eight domains and two summary scores decreased post pandemic, reflecting a decrease in QOL in HPN patients. As studies have shown the profound influence of the COVID-19 pandemic on both mental health and QOL measurements, clinicians need to consider the impact to our HPN patients who are at risk for overall lower baseline QOL scores. Routinely assessing a patient's QOL during HPN care may help identify areas of support needed to improve both clinical and QOL outcomes. The importance of this practice becomes even more apparent during a challenging experience like the COVID-19 pandemic. (Table Presented).