Annals for Hospitalists - 15 December 2020

Wesorick, David H.; Chopra, Vineet

doi:10.7326/awho202012150

Cited by 3 publications

(7 citation statements)

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“…The most common symptoms were fatigue (42.4%) and dyspnea (37.3%). Similar data were recently reported by four studies evaluating COVID-19 patients 60 [ 6 , 7 ], 90 [ 8 ], and 110 days [ 9 ] after hospital discharge and by a large Chinese study performed 6 months after hospital discharge [ 10 ]. Our data suggest that COVID-19 has a significant impact on patient mental well-being.…”

Section: Discussionsupporting

confidence: 87%

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COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge

et al. 2021

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Purpose Few data are currently available on persistent symptoms and late organ damage in patients who have suffered from COVID-19. This prospective study aimed to evaluate the results of a follow-up program for patients discharged from a nonintensive COVID-19 ward. Methods 3–6 months after hospital discharge, 59 of 105 COVID-19 patients (31 males, aged 68.2 ± 12.8 years) were recruited in the study. Forty-six patients were excluded because of nontraceability, refusal, or inability to provide informed consent. The follow-up consisted of anamnesis (including a structured questionnaire), physical examination, blood tests, ECG, lower limb compression venous ultrasound (US), thoracic US, and spirometry with diffusion lung capacity for carbon monoxide (DLCO). Results 22% of patients reported no residual symptoms, 28.8% 1 or 2 symptoms and 49.2% 3 or more symptoms. The most frequently symptoms were fatigue, exertional dyspnea, insomnia, and anxiety. Among the inflammatory and coagulation parameters, only the median value of fibrinogen was slightly above normal. A deep vein thrombosis was detected in 1 patient (1.7%). Thoracic US detected mild pulmonary changes in 15 patients (25.4%), 10 of which reported exertional dyspnea. DLCO was mildly or moderately reduced in 19 patients (37.2%), 13 of which complained of exertional dyspnea. Conclusion These results highlight that a substantial percentage of COVID-19 patients (77.8%) continue to complain of symptoms 3–6 months after hospital discharge. Exertional dyspnea was significantly associated with the persistence of lung US abnormalities and diffusing capacity alterations. Extended follow-up is required to assess the long-term evolution of postacute sequelae of COVID-19.

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Section: Discussionsupporting

confidence: 87%

“…At present, the available data from follow-up studies are limited. Preliminary analyses indicate that a substantial subset patients continue to complain of persistent symptoms after several months [ 6 – 10 ]. In some cases, organ damage is found, especially in the lungs [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge

et al. 2021

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“…The incidence of post-hospital functional decline at three months after discharge was 27.2%, slightly higher than the 22% described by Boyd et al in older people before the pandemic [ 4 ]. A quarter of patients worsened cognitively, and half of the patients had some depressive symptoms, an incidence similar to that found by Chopra et al [ 5 ].…”

Section: Discussionsupporting

confidence: 86%

“…Mortality at 3 months was 8.5%, lower than that described by Mas Romero et al in a residential setting (28%) [ 3 ] and lower than the 18.8% in older patients hospitalized for pneumonia of another cause [ 4 ] but only slightly higher than the 6.7% described at 2 months post-hospitalization in a cohort of COVID-19 patients with a median age of 62 years [ 5 ]. Most of the patients in the study had few comorbidities and a baseline situation of mild–moderate dependency that could explain these findings.…”

Section: Discussionmentioning

confidence: 72%

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Health status in survivors older than 70 years after hospitalization with COVID-19: observational follow-up study at 3 months

et al. 2021

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Key summary points Aim To describe associations between functionality, frailty, comorbidity, cognitive and affective status and mortality in a cohort of survivors older patients after hospital admission for SARS-CoV-2 infection. Findings Severe frailty pre-admission and severe functional dependency at discharge were associated with an increased risk of mortality and readmission at three months. In addition, high comorbidity or the need for readmission was also associated with mortality at 3 months. Message The knowledge of Health status in older people after hospitalization for COVID-19, means that its early detection can contribute to the selection of patients with greater risk of sequelae in the short term that require more careful follow-up.

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