Pre-hospital, in-hospital and post-hospital factors associated with sleep quality among COVID-19 survivors 6 months after hospital discharge: cross-sectional survey in five cities in China

Fu, Leiwen; Fang, Yuan; Luo, Dan; Wang, Bingyi; Xiao, Xin; Hu, Yuqing; Ju, Niu; Zheng, Weiran; Xu, Hui; Yang, Xue; Chan, Paul Shing Fong; Xu, Zhijie; Chen, Ping; He, Jiaoling; Zhu, Hongqiong; Tang, Huiwen; Huang, Dixi; Hong, Zhongsi; Ma, Xiaojun; Hao, Yanrong; Cai, Lianying; Yang, Jianrong; Ye, Shupei; Yuan, Jianhui; Chen, Yaoqing; Xiao, Fei; Wang, Zixin; Zou, Huachun

BACKGROUND: Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development. AIMS: This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge. METHOD: Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted. RESULTS: Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = −1.15, 95% CI = −1.70, −0.33) or death (adjusted B = −1.55, 95% CI = −2.62, −0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = −0.26, 95% CI = −0.31, −0.20), anxiety symptoms (adjusted B = −0.25, 95% CI = −0.33, −0.17), post-traumatic stress disorders (adjusted B = −0.16, 95% CI = −0.22, −0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10). CONCLUSIONS: COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.