Clinical Characteristics of Japanese Patients Who Visited a COVID-19 Aftercare Clinic for Post-Acute Sequelae of COVID-19/Long COVID

Abstract

The long-term clinical course, prognosis, and optimal management of symptoms and conditions after the acute phase of coronavirus disease 2019 remain to be elucidated. The purpose of this study was to clarify the characteristics of patients referred to a COVID-19 aftercare (CAC) clinic established at a tertiary academic hospital in Japan. MethodsThis study was a descriptive case series study. All patients who visited the CAC clinic between February 15 and September 17 in 2021 were included. Patients' background, chief complaints, and clinical courses after the onset of COVID-19 were described. ResultsA total of 87 Japanese patients (median age, 40.0 years; interquartile range [IQR], 26.5-53.0 years; 52.9% women) were referred to the CAC clinic. The median interval between the onset of COVID-19 and the visit to the clinic was 79.0 (IQR, 52.5-112.0) days. Referral sources were hospitals (36 patients), clinics (47 patients), a local healthcare center (3 patients), and other (1 patient). The most common chief complaint was general fatigue (50.4%) followed by dysosmia (28.7%), dysgeusia (26.4%), hair loss (18.4%), headache (17.2%), dyspnea (16.1%), and dyssomnia (13.1%). Respiratory symptoms were common in the early stages of the disease but were less common as the chief complaints when visiting the clinic. On the other hand, neurological, psychiatric, and extremity symptoms were predominant one month after the onset of COVID-19. ConclusionsRegardless of the severity in the acute phase, patients visiting our CAC clinic suffered from a variety of symptoms. General physicians skilled in using a comprehensive approach would be optimal to see patients with such complex symptoms.

Serial Changes of Long COVID Symptoms and Clinical Utility of Serum Antibody Titers for Evaluation of Long COVID

“…In this study, we obtained information for patients with long COVID directly through medical interviews and by physical examinations at our CAC. Studies on long COVID in Europe, the United States, China and Japan, [ 21 , 26 ] as well as a meta-analysis have gradually revealed the clinical characteristics and prognosis of long COVID [ 13 , 27 ]. However, most of the information for those studies was obtained from online or telephone interviews and there was no follow-up of the patients in those studies.…”

“…The reasons for establishing the clinic were to provide treatment for patients suffering from long COVID and to analyze the clinical characteristics of patients with long COVID in order to establish treatment strategies. Our previous study revealed that (i) most patients with long COVID had not required hospitalization in the acute phase and (ii) general fatigue was a major complaint in more than half of the patients [ 21 ].…”

Recovery From Alopecia After COVID-19

“…The supplementation of iron or zinc can be a treatment option for treating the deficiency of these minerals [9]. Although hair loss is not life-threatening, it can considerably affect the patient's quality of life; hence, physicians need to provide complete care for such patients [4]. Furthermore, physicians need to reduce anxiety by explaining to patients their conditions, sharing medical information, and eliminating their psychophysical stress by managing various systemic complications.…”

“…One month following discharge, he developed noticeable hair loss and observed shower clogging by the fallen hair daily (Figure 1). Because the hair loss continued, the patient visited our COVID-19 aftercare clinic four months after the first onset of COVID-19 [4]. By the first visit, alopecia had spread gradually across the entire head (Figure 2).…”

“…Studies have revealed that more than one-third of patients with COVID-19 develop a range of persistent symptoms after the acute phase of the infection [1][2]. Some symptoms remain and persist throughout the acute and chronic stages, whereas other symptoms newly appear after the acute phase [3][4]. Hair loss is not common in the acute phase of COVID-19 but is a well-known sequela of COVID-19 observed in approximately 20% of these patients [2].…”