Post-Hospital Recovery Experiences for Sepsis Survivors during the Covid-19 Pandemic

ABSTRACT

INTRODUCTION: Prior data indicate that sepsis survivors face persistent health challenges and fail to receive adequate support after hospital discharge. Delivery of high-quality transition care may be exacerbated by the COVID-19 pandemic. We assessed patient reported satisfaction with transitional care and health outcome status for survivors of respiratory sepsis (due to COVID-19 and non-COVID-19 pneumonia) during the pandemic. METHOD(S) We enrolled patients (or surrogate caregivers) from both usual care and intervention arms of ENCOMPASS, an ongoing clinical trial evaluating the effectiveness of a multicomponent sepsis transition program. Individuals who consented to participate completed health related quality of life (HRQoL;EQ-5D-5L) and other outcomes measures (Mini-MOCA, IES-6, mMRC) 3 months after hospital discharge and responded to questions about post-discharge support. Interviews were conducted via telephone. Data were collected in REDCap (Research Electronic Data Capture) and analyzed with SAS. RESULT(S) Among 18 participants (14 patients, 4 caregivers [non-overlapping]), 56% were female, median patient age was 67 years, median Charlson index was 4, median SOFA was 4, and 2 patients were recovering from COVID-19. Most reported being satisfied/very satisfied with their transitional care (15, 83%) and were able to get all of the healthcare services needed during the pandemic (14, 78%). Many participants reported persistent problems at 3 months after discharge (mobility [17, 94%], self-care [17, 94%], usual activities [18, 100%], pain or discomfort [17, 94%], and anxiety or depression [15, 83%]), independent of coexisting chronic disease burden. The median EQ-5D visual analog scale was 65 (IQR=40-80). 12 (86%) patients reported persistent dyspnea, 2 (14%) had cognitive impairment by mini-MOCA, and 3 (21%) had symptoms of post-traumatic stress by IES-6. CONCLUSION(S) Sepsis survivors experience multidimensional HRQoL problems 3 months after discharge. Despite concerns about the provision of transitional support during the pandemic, most patients in this small study were satisfied with the transitional support received. Our findings reinforce the need for high-quality transitional support that addresses the new or worsening health problems experienced after sepsis.