COVID‐19: Patient care after discharge from the Intensive Care Unit

Chadli, Asma; Haraj, Nassim Essabah; El Aziz, Siham; Laidi, Soukaina; Mounir, Anass; Bensbaa, Salma; Mjabber, Amal; Barrou, Lhoucine; El Kettani El Hamidi, Chafik; Nsiri, Afak; AL Harrar, Rachid; Ezzouine, Hanane; Charra, Boubaker; Kamal, Nabiha; Soussi Abdallaoui, Maha; Bennouna, Ghali Mohamed; Marhoum El Filali, Kamal; Mchichi Alami, Khadija; Agoub, Mohamed; El Mdaghri, Naima; Ramdani, Benyounes; Benghanem Gharbi, Mohamed; Afif, Moulay Hicham

INTRODUCTION: The Ibn Rochd CHU is a tertiary care structure that provides care for the most severe cases of COVID‐19 requiring hospitalization in intensive care. The objective of study is to describe the complementary medical and psychological care of patients with COVID‐19 in the endocrinology department after a stay in intensive care. PATIENTS AND METHODS: This is a descriptive observational study of patients transferred from the intensive care unit to the endocrinology service following a COVID‐19 infection during the period from 17 April 2020 to May 26, 2020. Clinical characteristics of the patients and complications related to COVID‐19 infection were studied; a nutritional assessment using the MNA nutritional status assessment questionnaire; psychological assessment using quality of life questionnaires (Hamilton depression and anxiety, HAD, SF36, PCLS); a treatment satisfaction questionnaire (TQCMII), and an assessment of patient autonomy by the ADL score. RESULT: Our study included 41 patients with an average age of 55 years (19‐85 years), a sex ratio M/F of 1.05, 43.9% were diabetic, 34.1% hypertensive, 4.9% asthmatic and 5% obese, 51.2% were severe and critical cases. The average ICU stay is 8.42 days, requiring intubation in 12.2% of cases. All patients were treated with the Hydroxychloroquine, Azithromycin, vitamin C, zinc and corticosteroid protocol, 14.6% had undernutrition and 65.9% had a risk of undernutrition. The average BMI was 25.34 kg / m² (17‐42), 61% had experienced weight loss, which was greater than 8kg in 26.1% of cases, 12.2 % of patients were not autonomous, 12.2% had moderate depression, 2.4% severe depression, 14.6% mild to moderate anxiety, 12.2% severe anxiety and 29.3% suffered acute post‐traumatic stress disorder. CONCLUSION: Patients with COVID‐19 are, in addition to the complications from coronavirus infection, vulnerable to undernutrition, psychological and motor complications. Additional care before discharge is essential for better integration of patients into their families.