PLoS ONE (Jan 2020)

Prevalence and risk factors of disability and anxiety in a retrospective cohort of 432 survivors of Coronavirus Disease-2019 (Covid-19) from China.

  • Siyi Zhu,
  • Qiang Gao,
  • Lin Yang,
  • Yonghong Yang,
  • Wenguang Xia,
  • Xiguo Cai,
  • Yanping Hui,
  • Di Zhu,
  • Yanyan Zhang,
  • Guiqing Zhang,
  • Shuang Wu,
  • Yiliang Wang,
  • Zhiqiang Zhou,
  • Hongfei Liu,
  • Changjie Zhang,
  • Bo Zhang,
  • Jianrong Yang,
  • Mei Feng,
  • Zhong Ni,
  • Baoyu Chen,
  • Chunping Du,
  • Hongchen He,
  • Yun Qu,
  • Quan Wei,
  • Chengqi He,
  • Jan D Reinhardt

DOI
https://doi.org/10.1371/journal.pone.0243883
Journal volume & issue
Vol. 15, no. 12
p. e0243883

Abstract

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ObjectiveTo estimate the prevalence of disability and anxiety in Covid-19 survivors at discharge from hospital and analyze relative risk by exposures.DesignMulti-center retrospective cohort study.SettingTwenty-eight hospitals located in eight provinces of China.MethodsA total of 432 survivors with laboratory-confirmed SARS CoV-2 infection participated in this study. At discharge, we assessed instrumental activities of daily living (IADL) with Lawton's IADL scale, dependence in activities of daily living (ADL) with the Barthel Index, and anxiety with Zung's self-reported anxiety scale. Exposures included comorbidity, smoking, setting (Hubei vs. others), disease severity, symptoms, and length of hospital stay. Other risk factors considered were age, gender, and ethnicity (Han vs. Tibetan).ResultsPrevalence of at least one IADL problem was 36.81% (95% CI: 32.39-41.46). ADL dependence was present in 16.44% (95% CI: 13.23-20.23) and 28.70% (95% CI: 24.63-33.15) were screened positive for clinical anxiety. Adjusted risk ratio (RR) of IADL limitations (RR 2.48, 95% CI: 1.80-3.40), ADL dependence (RR 2.07, 95% CI 1.15-3.76), and probable clinical anxiety (RR 2.53, 95% CI 1.69-3.79) were consistently elevated in survivors with severe Covid-19. Age was an additional independent risk factor for IADL limitations and ADL dependence; and setting (Hubei) for IADL limitations and anxiety. Tibetan ethnicity was a protective factor for anxiety but a risk factor for IADL limitations.ConclusionA significant proportion of Covid-19 survivors had disability and anxiety at discharge from hospital. Health systems need to be prepared for an additional burden resulting from rehabilitation needs of Covid-19 survivors.