Objectives To describe the prevalence, nature, and risk factors for the main clinical sequelae in COVID-19 survivors who have been discharged from the hospital for more than 3 months. Methods This longitudinal study was based on a telephone follow-up survey of COVID-19 patients hospitalized and discharged from Renmin Hospital of Wuhan University, Wuhan, China before March 1, 2020. Demographic and clinical characteristics and self-reported clinical sequelae of the survivors were described and analysed. A cohort of volunteers who were free of COVID-19 and lived in the urban area of Wuhan during the outbreak were also selected as the comparison group. Results Among 538 survivors (293[54.5%] female), the median age was 52.0 years (IQR 41.0–62.0), and the median time from discharge from hospital to first follow-up was 97.0 days (IQR 95.0–102.0). Clinical sequelae were common, including general symptoms (n=267, 49.6%), respiratory symptoms (n=210, 39%), cardiovascular-related symptoms (n=70, 13%), psychosocial symptoms (n=122, 22.7%) and alopecia (n=154, 28.6%). We found that physical decline/fatigue (P<0.01), post-activity polypnea (P=0.04) and alopecia (P<0.01) were more common in females than in males. Dyspnoea during hospitalization was associated with subsequent physical decline/fatigue, post-activity polypnea and resting heart rate increases, but not specifically with alopecia. A history of asthma during hospitalization was associated with subsequent post-activity polypnea sequela. A history of pulse ≥90 beats per min during hospitalization was associated with resting heart rate increase in convalescence. The duration of viral shedding after COVID-19 onset and hospital length of stay were longer in survivors with physical decline/fatigue or post-activity polypnea than in those without. Conclusion Clinical sequelae during early COVID-19 convalescence were common, and some of these sequelae might be related to gender, age and clinical characteristics during hospitalization.

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Emerging evidence suggests that gut-brain-microbiota axis (GBMAx) may play a pivotal role linking gastrointestinal and neuronal disease. In this review, we summarize the latest advances in studies of GBMAx in inflammatory bowel disease (IBD) and ischemic stroke. A more thorough understanding of the GBMAx could advance our knowledge about the pathophysiology of IBD and ischemic stroke and help to identify novel therapeutic targets via modulation of the GBMAx.

Highlights We investigated the prevalence and recovery time of olfactory and gustatory dysfunction in COVID-19 patients in Wuhan, China. This retrospective study of 196 patients with COVID-19 found that 8.2% and 4.6% of patients reported olfactory and taste disorders, respectively. Recovery from chemosensory dysfunction (OD and/or GD) was slow, with over half of the patients taking more than 4 weeks to recover. Patients with COVID-19 and olfactory and/or gustatory dysfunctions had significantly higher rates of cardiovascular disease than patients without olfactory and/or gustatory dysfunctions. The results indicate that the prevalence and prognosis of olfactory or gustatory impairment in COVID-19 patients vary globally, reflecting the complexity of this disease.

Background Epidemiological and clinical features of patients with corona virus disease 2019 (COVID-19) were well delineated. However, no researches described the patients complicated with pleural effusion (PE). In the present study, we aimed to clinically characterize the COVID-19 patients complicated with PE and to create a predictive model on the basis of PE and other clinical features to identify COVID-19 patients who may progress to critical condition. Methods This retrospective study examined 476 COVID-19 inpatients, involving 153 patients with PE and 323 without PE. The data on patients’ past history, clinical features, physical checkup findings, laboratory results and chest computed tomography (CT) findings were collected and analyzed. LASSO regression analysis was employed to identify risk factors associated with the severity of COVID-19. Results Laboratory findings showed that patients with PE had higher levels of white blood cells, neutrophils, lactic dehydrogenase, C-reactive protein and D-dimer, and lower levels of lymphocytes, platelets, hemoglobin, partial pressure of oxygen and oxygen saturation. Meanwhile, patients with PE had higher incidence of severe or critical illness and mortality rate, and longer hospital stay time compared to their counterparts without pleural effusion. Moreover, LASSO regression analysis exhibited that pleural effusion, lactic dehydrogenase (LDH), D-dimer and total bilirubin (TBIL) might be risk factors for critical COVID-19. Conclusions Pleural effusion could serve as an indicator for severe inflammation and poor clinical outcomes, and might be a complementary risk factor for critical type of COVID-19.