Table 3.
Univariate and multivariate factors associated with the worsening of quality of life (QOL), as assessed by the EQ-5D-5L tool, in COVID-19 survivors at one-year follow-up. Pre-COVID clinical frailty scale (CFS) and 5-level EQ-5D cumulative values were forced into the multivariate Cox regression model. Expected survival at 1 year was calculated based on the data obtained from the Italian Registry of population in 2019. Time was calculated from index ED admission for COVID. Proportions are reported as row percentages.
| Stable QOL N 100 | Worsened QOL N 136 | p Value | Hazard Ratio [95% Confidence Interval] |
Multivariate p Value | |
|---|---|---|---|---|---|
| Age | 83 [81, 86] | 84 [81, 87] | 0.11 | 1.01 [0.96, 1.06] | 0.65 |
| Age 80–85 years | 62 (47.7%) | 69 (52.3%) | |||
| Age 85–89 years | 24 (32.0%) | 51 (68.05%) | 0.03 | ||
| Age 90–94 years | 9 (37.5%) | 15 (62.5%) | |||
| Age ≥ 95 years | 5 (83.3%) | 1 (16.7%) | |||
| Expected Survival/1 year | 69.4% [49.7, 69.4] | 69.4% [49.7, 69.4] | 0.22 | ||
| Sex (male) | 60 (52.2%) | 55 (47.8%) | <0.01 | 0.69 [0.48, 0.98] | 0.04 |
| CFS pre-COVID | 4 [3, 5] | 5 [4, 5] | 0.03 | 1.01 [0.87, 1.17] | 0.896 |
| Resident in nursing home | 16 (38.1%) | 26 (71.9%) | 0.59 | ||
| Autonomous in ADL pre-COVID | 80 (43.9%) | 102 (56.1%) | 0.37 | ||
| EQ-5D-5L before COVID (cumulative) | 7 [5, 9] | 12 [8, 14] | 0.03 | 1.00 [0.95, 1.05] | 0.91 |
| Clinical characteristics of the COVID-19 disease | |||||
| PaO2/FiO2 at ED admission | 290 [233, 346] | 288 [226, 346] | 0.96 | ||
| NEWS at ED admission | 5 [4, 6] | 5.5 [5, 7] | 0.39 | ||
| NEWS > 5 at ED admission | 3 (50.0%) | 3 (50.0%) | 0.70 | ||
| Consolidation at chest X-ray | 80 (39.8%) | 121 (60.2%) | 0.05 | ||
| Delirium | 7 (50.0%) | 7 (50.0%) | 0.55 | ||
| Mechanical ventilation | 33 (40.7%) | 48 (59.3%) | 0.71 | ||
| Length of hospital stay (days) | 13.6 [9.0, 21.3] | 12.4 [7.26, 22.4] | 0.46 | ||
| Comorbidities | |||||
| CCI | 5 [4, 6] | 5 [4, 6] | 0.78 | ||
| Comorbidities ≥ 3 | 32 (45.7%) | 38 (54.3%) | 0.43 | ||
| Hypertension | 46 (58.3%) | 74 (61.7%) | 0.20 | ||
| History of CAD | 20 (54.0%) | 17 (66.0%) | 0.12 | ||
| Congestive heart failure | 13 (40.6%) | 19 (59.4%) | 0.83 | ||
| Cerebrovascular disease | 3 (50.0%) | 3 (50.0%) | 0.70 | ||
| Dementia | 11 (39.3%) | 17 (60.7%) | 0.72 | ||
| COPD | 15 (41.7%) | 21 (58.3%) | 0.93 | ||
| Diabetes | 21 (39.6%) | 32 (60.4%) | 0.64 | ||
| Chronic kidney disease | 8 (42.1%) | 11 (57.9%) | 0.98 | ||
| Malignancy | 0 | 3 (2.2%) | 0.26 | ||
| Outcomes at Follow-up | |||||
| Total follow-up (months) | 17 [15, 18.7] | 17 [15, 18] | 0.13 | ||
| CFS 1-year after COVID | 4 [3, 5] | 5 [4, 7] | <0.01 | ||
| EQ-5D-5L 1-year after COVID | 8 [6, 11] | 12 [9, 16] | <0.01 | ||
| Persistent COVID symptoms | 0 [0, 1] | 0 [0, 1] | <0.01 | ||
| Re-hospitalization <1 year | 14 (40.0%) | 35 (60.0%) | 0.05 | ||
Abbreviations: CCI: Charlson Comorbidity Index; ADL: activities of daily living; CAD: coronary artery disease; COPD: chronic obstructive pulmonary disease; NEWS: national early warning score.