Longitudinal Smartphone-Based Post-hospitalisation Symptom Monitoring in SARS-CoV-2 Associated Respiratory Failure: A Multi-Centre Observational Study

Dario Kohlbrenner; Manuel Kuhn; Melina Stüssi-Helbling; Yves Nordmann; Marc Spielmanns; Christian F Clarenbach

doi:10.3389/fresc.2021.777396

Longitudinal Smartphone-Based Post-hospitalisation Symptom Monitoring in SARS-CoV-2 Associated Respiratory Failure: A Multi-Centre Observational Study

Front Rehabil Sci. 2021 Nov 24:2:777396. doi: 10.3389/fresc.2021.777396. eCollection 2021.

Authors

Dario Kohlbrenner^{1

2}, Manuel Kuhn^{1

2}, Melina Stüssi-Helbling³, Yves Nordmann⁴, Marc Spielmanns^{5

6}, Christian F Clarenbach²

Affiliations

¹ Faculty of Medicine, University of Zurich, Zurich, Switzerland.
² Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
³ Clinic of Internal Medicine, Department of Internal Medicine, Triemli Hospital, Zurich, Switzerland.
⁴ docdok.health, Basel, Switzerland.
⁵ Department of Pulmonary Rehabilitation, Zürcher Rehazentren Klinik Wald, Wald, Switzerland.
⁶ Department of Pulmonary Medicine, Faculty of Health, University Witten-Herdecke, Witten, Germany.

Abstract

Background: We aimed to longitudinally monitor the recovery in breathlessness, symptom burden, health-related quality-of-life, and mental health status in individuals hospitalised due to SARS-CoV-2 associated respiratory failure. Methods: Individuals hospitalised due to SARS-CoV-2 associated respiratory failure were recruited at hospital discharge in three participating centres. During the 90 day follow-up, European Quality of Life-5 Dimensions-5 Levels Instrument (EQ-5D-5L), modified Medical Research Council (mMRC) Dyspnoea Scale, COPD Assessment Test (CAT), and weekly Hospital Anxiety and Depression Scale (HADS) questionnaires were assessed using a smartphone application. The results were presented using descriptive statistics and graphics. Linear mixed models with random intercept were fitted to analyse differences of intensive-care unit status on the recovery course in each outcome. Results: We included 58 participants, 40 completed the study. From hospital discharge until 90 days post-discharge, EQ-5D-5L index changed from 0.83 (0.66, 0.92) to 0.96 (0.82, 1.0), VAS rating on general health status changed from 62 (50, 75) % to 80 (74, 94) %, CAT changed from 13 (10, 21) to 7 (3, 11) points, mMRC changed from 1 (0, 2) to 0 (0, 1) points, HADS depression subscale changed from 6 (4, 9) to 5 (1, 6) points, HADS anxiety subscale changed from 7 (3, 9) to 2 (1, 8) points. Differences in the recovery courses were observed between intensive-care and ward participants. Participants that were admitted to an intensive-care unit during their hospitalisation (n = 16) showed increases in CAT, mMRC, HADS scores, and decreases in EQ-5D-5L 30 days after hospital discharge. Conclusion: Being admitted to an ICU led to statistically significant reductions in recovery in the EQ-5D-5L and the CAT. Furthermore, the flare-up in symptom burden and depression scores, accompanied by an attenuated recovery in HrQoL and general health status in the ICU-group suggests that a clinical follow-up 1 month after hospital discharge can be recommended, evaluating further treatments. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT04365595].

Keywords: COVID-19; SARS-CoV-2; home-monitoring; mental health; quality-of-life; respiratory failure.

Associated data

ClinicalTrials.gov/NCT04365595