M.H. Gerards1,2, A.I. Slotegraaf3, A.C. Verburg4, M.A. de van der Schueren5,3, H.M. Kruizenga6, M.J. Graff7,4, E.H. Cup7, J.G. Kalf7, A.F. Lenssen2, W.M. Meijer8, R.A. Kool9, R.A. de Bie1, P.J. van der Wees4,7, T.J. Hoogeboom4, - on behalf of the Dutch Consortium Allied Healthcare COVID-1910
1Maastricht University, Department of Epidemiology, Care and Public Health Institute (CAPHRI), Maastricht, Netherlands, 2Maastricht university medical centre, Department of Physical Therapy, Maastricht, Netherlands, 3Wageningen University and Research, Division of Human Nutrition and Health,, Wageningen, Netherlands, 4Radboud university medical centre,, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, Netherlands, 5HAN University of Applied Sciences, Department of Nutrition, Dietetics and Lifestyle, Nijmegen, Netherlands, 6Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Nutrition & 24 Dietetics, Amsterdam Movement Sciences, Aging and Vitality, Amsterdam, Netherlands, 7Radboud university medical centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Nijmegen, Netherlands, 8Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands, 9Lung Foundation Netherlands, Amersfoort, Netherlands, 10-, -, Netherlands
Background: An estimated 32–57% of patients recovering from a COVID-19 infection experience severe and long-term problems in daily functioning and participation. To date, it is unknown what treatment is needed to support patients in their recovery from COVID-19.
Purpose: To report the recovery of patients receiving primary allied health care after a COVID-19 infection at a six-month follow-up, and to explore which patient characteristics are associated with the changes in outcomes between the baseline and six-month follow-up.
Methods:Design: Prospective cohort study.
Setting: Allied health care in Dutch primary care.
Participants: 1,452 adult patients recovering from COVID-19 and receiving treatment from one or more primary care allied health professional(s) (i.e., dietitian, exercise therapist, occupational therapist, physical therapist and/or speech and language therapist).
Main outcome measures: The patient-reported outcome domains of participation, health-related quality of life (HRQoL), fatigue and physical functioning were assessed at the baseline, and after three and six months. Data on psychological well-being were collected at the baseline and after six months.
Setting: Allied health care in Dutch primary care.
Participants: 1,452 adult patients recovering from COVID-19 and receiving treatment from one or more primary care allied health professional(s) (i.e., dietitian, exercise therapist, occupational therapist, physical therapist and/or speech and language therapist).
Main outcome measures: The patient-reported outcome domains of participation, health-related quality of life (HRQoL), fatigue and physical functioning were assessed at the baseline, and after three and six months. Data on psychological well-being were collected at the baseline and after six months.
Results: For participation, measured with the USER-P (range 0 to 100), estimated mean differences of at least 2.3 points (p< 0.001) were observed after three and six months. For HRQoL, measured with EQ-VAS (range 0 to 100), the mean increase was 9.00 (95% CI 7.8 to 10.3) at three months and 12.31 (11.1 to 13.6) at six months. Furthermore, significant improvements were found for fatigue, measured with the FSS (range 1 to 7): the mean decrease was –0.4 (95% CI –0.50 to –0.4) at three months and –0.7 (95% CI –0.8 to –0.6) at six months. For physical functioning, measured with the PROMIS-PF (range 13.8 to 61.3), the mean increase was 3.9 (95% CI 3.5 to 4.3) at three months and 5.9 (5.6 to 6.4) at six months. Mean differences of –0.8 (95% CI –1.0 to –0.5) for anxiety, measured with the HADS anxiety score (range 0 to 21), and –1.5 (–1.8 to –1.3) for depression, measured with the HADS depression score (range 0 to 21), were found after six months. A better baseline score, hospital admission and male sex were associated with a positive change in score between the baseline and six-month follow-up, whereas age, BMI, comorbidities and smoking status were not associated with mean changes in any outcome measure.
Conclusions: Patients recovering from COVID-19 who receive primary allied health care make progress in recovery, but still experience many limitations in their daily activities after six months. Our findings provide reference values to healthcare providers and healthcare policy-makers regarding what to expect from the recovery of patients who received health care from one or more primary care allied health professionals.
Implications: Patients receiving primary allied health care after a COVID-19 infection make progress in recovery, but still experience limitations in their daily activities six months after starting treatment with one or more primary allied health professional(s). This study provides reference values to healthcare providers about what to expect from the recovery of patients who receive health care from one or more primary allied health professional(s).
Funding acknowledgements: We would like to acknowledge ZonMw Efficiency Studies (10390062010001) for their funding
Keywords:
COVID-19
Primary care
COVID-19
Primary care
Topics:
COVID-19
Primary health care
COVID-19
Primary health care
Did this work require ethics approval? Yes
Institution: Radboud university medical centre
Committee: Medical ethics committee
Ethics number: Registration #2020-7278
All authors, affiliations and abstracts have been published as submitted.
