Dermatology & Plastic Surgery Institute Outcomes

Analysis of data collected from Cleveland Clinic ReCOVer Clinic patients (February to November 2021) who completed the Patient-Reported Outcomes Measurement (PROMIS) Sleep Disturbance and PROMIS Fatigue questionnaires was performed. Data were extracted from Cleveland Clinic's COVID-19 registry and the electronic health record. Scores were standardized and compared with the general US adult population on a T-scale of 50 ± 10. PROMIS sleep disturbance and fatigue scores ≥ 60 indicate moderate disturbance and ≥ 70 indicate severe disturbance. T-test and Chi-square tests were used to examine cross-group differences. Multivariable logistic regression adjusted for age, race, sex, and body mass index (kg/m2) was performed to investigate factors associated with sleep disturbance severity. Out of 1321 patients, 682 patients completed the PROMIS Sleep Disturbance questionnaire with ages 49.8 ± 13.6, 75.2% female, and 12.3% Black. Average T-scores were 57.7 ± 8.3; 281 (41.2%) patients reported at least moderate sleep disturbance and 50 (7.3%) reported severe sleep disturbances. Seven hundred patients completed the PROMIS Fatigue questionnaire with average T-score of 63 ± 9.2, of which 68.3% reported at least moderate fatigue and 22.9% reported severe fatigue. Patients with moderate-severe compared with normal-to-mild sleep disturbances, respectively, had higher BMI (32.3 ± 8.7 vs 30.9 ± 7.5, P = 0.049), Black race (40 ± 10 vs 41 ± 15.7, P = 0.010), general anxiety disorder (GAD)-2 questionnaire scores (2.8 ± 2.1 vs 1.6 ± 1.7, P < 0.001), Patient Health Questionnaire (PHQ)-2 scores (2.8 ± 2 vs 1.6 ± 1.7, P < 0.001), and PROMIS fatigue scores (66.7 ± 7.8 vs 60.4 ± 9.1, P < 0.001) with no difference in age, sex, or hospitalization due to COVID-19. In the adjusted model, Black race was associated with moderate-severe sleep disturbance (OR = 3.42, 95% CI, 1.64-7.13).