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

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

doi:10.1192/bjo.2021.1008

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

BJPsych Open. 2021 Oct 11;7(6):e191. doi: 10.1192/bjo.2021.1008. eCollection 2021 Nov.

Authors

Leiwen Fu¹, Yuan Fang², Dan Luo¹, Bingyi Wang¹, Xin Xiao³, Yuqing Hu¹, Niu Ju¹, Weiran Zheng¹, Hui Xu¹, Xue Yang⁴, Paul Shing Fong Chan⁴, Zhijie Xu⁵, Ping Chen⁵, Jiaoling He⁵, Hongqiong Zhu⁵, Huiwen Tang⁵, Dixi Huang⁵, Zhongsi Hong⁵, Xiaojun Ma⁶, Yanrong Hao⁷, Lianying Cai⁸, Jianrong Yang⁹, Shupei Ye¹⁰, Jianhui Yuan¹¹, Yaoqing Chen¹, Fei Xiao⁵, Zixin Wang⁴, Huachun Zou¹²

Affiliations

¹ School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.
² Department of Early Childhood Education, The Education University of Hong Kong, Hong Kong SAR, China.
³ School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China, and Center for Optometry and Visual Science, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
⁴ JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁵ The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
⁶ Guangdong Provincial People's Hospital, Guangzhou, China.
⁷ Department of Scientific Research, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
⁸ Department of Education, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
⁹ Department of Hepatobiliary, Pancreas and Spleen Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
¹⁰ Department of emergency, SSL Central Hospital of Dongguan City, Dongguan, China.
¹¹ Shenzhen Nanshan District Center for Disease Control and Prevention, Shenzhen, China.
¹² School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China; Kirby Institute, University of New South Wales, Sydney, Australia; Shenzhen Center for Disease Control and Prevention, Shenzhen, China; and School of Public Health, Shanghai Jiao Tong University, Shanghai, China.

Abstract

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.

Keywords: COVID-19 survivors; China; in-hospital factors; post-hospital factors; pre-hospital factors; sleep quality.