COVID-19 Patients in the COVID-19 Recovery and Engagement (CORE) Clinics in the Bronx

Abstract

Background: Early in the pandemic, we established COVID-19 Recovery and Engagement (CORE) Clinics in the Bronx and implemented a detailed evaluation protocol to assess physical, emotional, and cognitive function, pulmonary function tests, and imaging for COVID-19 survivors. Here, we report our findings up to five months post-acute COVID-19. Methods: Main outcomes and measures included pulmonary function tests, imaging tests, and a battery of symptom, physical, emotional, and cognitive assessments 5 months post-acute COVID-19. Findings: Dyspnea, fatigue, decreased exercise tolerance, brain fog, and shortness of breath were the most common symptoms but there were generally no significant differences between hospitalized and non-hospitalized cohorts (p > 0.05). Many patients had abnormal physical, emotional, and cognitive scores, but most functioned independently; there were no significant differences between hospitalized and non-hospitalized cohorts (p > 0.05). Six-minute walk tests, lung ultrasound, and diaphragm excursion were abnormal but only in the hospitalized cohort. Pulmonary function tests showed moderately restrictive pulmonary function only in the hospitalized cohort but no obstructive pulmonary function. Newly detected major neurological events, microvascular disease, atrophy, and white-matter changes were rare, but lung opacity and fibrosis-like findings were common after acute COVID-19. Interpretation: Many COVID-19 survivors experienced moderately restrictive pulmonary function, and significant symptoms across the physical, emotional, and cognitive health domains. Newly detected brain imaging abnormalities were rare, but lung imaging abnormalities were common. This study provides insights into post-acute sequelae following SARS-CoV-2 infection in neurological and pulmonary systems which may be used to support at-risk patients and develop effective screening methods and interventions.

Incidence of New-Onset Hypertension Post–COVID-19: Comparison With Influenza

“…Time to event survival analysis could be used to gain further insights into the evaluation of new-onset hypertension As with any retrospective study, there could be other unintended patient selection bias and latent confounding. 39,40…”

Longitudinal Chest X-ray Scores and their Relations with Clinical Variables and Outcomes in COVID-19 Patients

“…We did not compare different SARS-CoV-2 variants and thus this study cannot be generalized to different variants. There have been many studies demonstrating the value of utilizing machine/deep learning algorithms to detect SARS-CoV-2 infection using CXR scores [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 41 ]; it would be interesting to see whether CXR scores generated by machine/deep learning would produce similar results to those presented in this paper.…”

“…CT is, however, prone to cross-contamination and, thus, it is not widely used in the context of COVID-19 in the United States and elsewhere in the world, especially in the intensive care setting, due to the risk of cross-infection. By contrast, a portable chest X-ray (CXR) is convenient, readily available, can be brought to the patient’s bedside, and can be readily disinfected between uses [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Although a CXR has inferior diagnostic quality to CT, CXRs can be used to visualize characteristic ground-glass opacities and consolidation in the lungs associated with COVID-19 infection, helping with clinical diagnosis [ 17 ].…”

Long‐term clinical outcomes and healthcare utilization of sickle cell disease patients with COVID‐19: A 2.5‐year follow‐up study

“…In addition to having a large SCD patient cohort, our cohort consisted of a large proportion of patients with lower socioeconomic status. [32][33][34][35][36][37][38] We found there were no group differences with respect to insurance status and household median income, although there were trends of COVID-19 status showing a higher rate of uninsured status and Medicaid and lower household median income.…”