Associations of Post-Acute COVID syndrome with physiological and clinical measures 10 months after hospitalization in patients of the first wave

Abstract

Background: For a better understanding of the factors underlying the Post-Acute COVID Syndrome, we studied the relationship between symptoms and functional alterations in COVID-19 patients 10 months after hospitalization. Methods: One-hundred-one patients hospitalized between March 1st and June 30th 2020 participated in a followup visit for an assessment of clinical history, comorbidities, lung function, physical capacity and symptoms, including the SGRQ for health-related quality of life, PHQ-9-D for depression, and SOMS-2 J for somatoform disorders. Data were analyzed by univariate comparisons and multiple logistic regression analyses. Results: Median age was 60 years, 42% were female, 76% had at least one comorbidity, the median length of the hospital stay was 8 days, 19% had been on the ICU. The most prevalent symptoms included shortness of breath (49%), fatigue (49%) and cognitive impairment (39%). Signs of major depression (PHQ-9-D ≥ 10) occurred in 28%/2% (p < 0.05) of patients with/without self-reported cognitive impairment, with median total SGRQ score being 25.4/5.3 (p < 0.05). There were associations between shortness of breath and BMI, SGRQ and hemoglobin levels; between fatigue, SGRQ and PHQ-9-D; and between cognitive impairment and PHQ-9-D (p < 0.05 each) but not with lung function or physical capacity. Characteristics of the acute disease were not related to symptoms. Conclusions:The findings demonstrate that 10 months after discharge from a hospital stay due to COVID-19, the percentages of patients with symptoms were high. Symptoms showed a consistent pattern but could not be attributed to altered lung function or physical capacity. Our results suggest a role for alternative etiologies including psychosocial factors.

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.…”

Exploring the recovery curve for long-term post-COVID dyspnea and fatigue

“…The presence of post-COVID fatigue is associated with worse quality of life [4] . Damage in lung function is proposed as a hypothesis for the presence of respiratory post-COVID; however, a recent study has observed that lung function and exercise capacity are almost normal 10-months after the infection albeit the presence of post-COVID symptoms [5] .…”

“…Most studies investigating post-COVID fatigue and dyspnea are cross-sectional since they assessed the presence of these symptoms at one follow-up period [2] , [3] , [4] , [5] . Two longitudinally assessing symptoms during the first year after infection reported different results.…”

Brief Research Report: Quantitative Analysis of Potential Coronary Microvascular Disease in Suspected Long-COVID Syndrome

“…A recent study evaluated the relationship between symptoms and functional alterations in hospitalized COVID-19 patients. The findings demonstrated that while 10 months after discharge from a hospital stay due to COVID-19 the percentages of patients with symptoms were high, those symptoms could not be attributed to altered lung function or physical capacity ( 12 ).…”