Assessment of Sequelae of COVID-19 Nearly 1 Year After Diagnosis

Abstract

Background: A previous study has shown that 81% of the COVID-19 patients had mild or moderate symptoms. However, most studies on the sequelae in COVID-19 patients focused on severe cases and the long-term follow-up studies on the health consequences in non-severe cases are limited. The current study aimed to assess the sequelae of COVID-19 in patients nearly 1 year after diagnosis with a particular focus on the recovery of patients with non-severe COVID-19.Methods: We enrolled 120 patients infected with SARS-CoV-2 discharged from Wuhan Union hospital west district (designated hospital for COVID-19) and Fangcang shelter hospitals between January 29, 2020 and April 1, 2020. All participants were asked to complete a series of questionnaires to assess their symptoms and quality of life and for psychological evaluation. Also, pulmonary function test, chest CT, 6-min walking test (6MWT), routine blood test, liver and kidney function tests, fasting blood glucose test, lipid test, and immunoglobulin G antibody test were performed to evaluate their health.Results: The mean age of the study population was 51.6 ± 10.8 years. Of the 120 patients, 104 (86.7%) were cases of non-severe COVID-19. The follow-up study was performed between November 23, 2020 and January 11, 2021, and the median time between the diagnosis and the follow-up was 314.5 (IQR, 296–338) days. Sleep difficulties, shortness of breath, fatigue, and joint pain were common symptoms observed during follow-up and nearly one-third of the non-severe cases had these symptoms. A total of 50 (41.7%) and 45 (37.5%) patients reported anxiety and depression, respectively. And 18.3% of the patients showed negative results in the IgG test at the follow-up, which correlated with the severity of the infection (R = 0.203, p = 0.026), and the proportion of IgG negative cases in non-severe COVID-19 patients was higher than that in the severe cases (20.2 vs. 6.3%). Pulmonary diffusion impairment was reported in 30 (26.1%) out of 115 patients, and 24 (24.2%) out of the 99 non-severe cases. The values of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FVC/FEV1, vital capacity (VC), total lung capacity (TLC), and residual volume (RV) were less than the normal range in 1.7, 8.6, 0.9, 11.2, 7.0, and 0.9% of the patients, respectively. A total of 55 (56.7%) out of the 97 patients showed abnormal CT findings, including ground-glass opacities (GGO), bronchiectasis, nodules, lines and bands, and fibrosis. Furthermore, there was a correlation between all the SF-36-domain scores and the duration of hospitalization, pulmonary function, and a 6MWT.Conclusions: At the nearly 1-year follow-up, COVID-19 survivors still had multi-system issues, including those in the respiratory functioning, radiography, quality of life, and anxiety and depression. Moreover, non-severe cases also showed some sequelae and the proportion of IgG negative cases in the non-severe patients was higher than that in severe cases. Therefore, conducting follow-ups and preventing the reinfection of SARS-CoV-2 in this group is necessary.

Long-Term Consequences of COVID-19 at 6 Months and Above: A Systematic Review and Meta-Analysis

“…Among the 193 studies under full-text review, 153 studies were excluded. Eventually, 40 studies were included in this meta-analysis based on the inclusion criteria [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. The literature retrieval flow chart is shown in Figure 1 .…”

Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study

“…Mental health disorders after acute COVID-19, including mainly anxiety, depression, and PTSD, have attracted widespread attention, but the prevalence varies widely among studies. 7 , 37 , 38 , 39 , 40 , 41 , 42 , 43 Mental health problems after COVID-19 might be attributed to the direct effects of SARS-CoV-2 infection, isolation, physical distancing, incomplete recovery of physical health, and financial difficulties. 26 , 44 An encouraging finding of our study was that the proportion of participants with anxiety or depression gradually decreased throughout the 2 years, regardless of initial disease severity.…”

“…Different assessment methods for mental health might partly explain the huge variation in the prevalence of mental health disorders after COVID-19 in previous studies. 7 , 37 , 38 , 39 , 40 , 41 , 42 , 43 In fact, due to the high heterogeneity of follow-up studies of COVID-19, differences were also observed in long COVID prevalence and obscured our understanding of it. 26 Hence, there is an urgent need to develop norms to reduce heterogeneity among studies, such as core outcome sets (especially for symptoms requiring priority evaluation), validated assessment tools, broadly recognised symptom questionnaires, and specific follow-up timepoints.…”

“…Given the huge number of individuals who have recovered from COVID-19 up to now, the sequelae after recovery from acute COVID-19 are undoubtedly a great health concern and might cause a big medical and socioeconomic burden. Several cohort studies have highlighted that the health effects of COVID-19 could persist up to 1 year after acute infection, 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 most of which had no control groups of individuals who had not contracted COVID-19 and focused only on symptomatic sequelae or respiratory outcomes. Hence, long-term (ie, beyond 1 year) and overall health outcomes of COVID-19 are largely unknown.…”

ESCMID rapid guidelines for assessment and management of long COVID

“…4% Loss of appetite 1-9% # Reference: [27] $ Reference: [25] § Reference: [28,29,[123][124][125] J o u r n a l P r e -p r o o f J o u r n a l P r e -p r o o f…”