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 and 3 others
PMID 36188784WHAT IT FOUND
Most hospitalised patients recovered steadily over three months, but those who had an ICU stay showed a distinct flare-up in symptoms and depression around one month after discharge.
Clinicians should schedule a systematic assessment at that time to catch this deterioration.
Key findings
01Patients who had an ICU stay experienced a flare-up in symptom burden and depression scores, along with attenuated recovery in health-related quality of life, approximately one month after hospital discharge.
02Overall symptom burden recovered to a low-impact level within 20 days for the general group, but the ICU subgroup showed an increase in symptoms between day 25 and day 55.
03Adherence to daily smartphone-based monitoring was high, suggesting this method is feasible for tracking recovery in outpatient settings.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was small (58 participants), and 18 withdrew consent, creating potential selection bias. There were no pre-hospitalisation baseline measurements, so it is unclear if some reported impairments existed before the infection. The study did not track outpatient rehabilitation or other interventions participants may have received during the monitoring period, which could have influenced recovery. The EQ-5D-5L may have missed subtle losses in activity for previously highly active individuals due to ceiling effects.
Declared interests
The work was supported by Astra Zeneca through a university foundation fund. One author is a co-founder and Chief Medical Officer of the smartphone platform (docdok.health) used in the study, with a financial interest in its commercialisation. Other authors have received fees from various pharmaceutical companies for unrelated work.
The easy way to misread this
Do not assume that all hospitalised patients recover on a steady upward curve. The study found that ICU survivors specifically experienced a worsening of symptoms and depression around one month post-discharge, which could be missed if follow-up is only scheduled for later or earlier time points.