Dynamic changes of functional fitness, antibodies to SARS-CoV-2 and immunological indicators within 1 year after discharge in Chinese health care workers with severe COVID-19: a cohort study

Abstract

Background Few studies had described the health consequences of patients with coronavirus disease 2019 (COVID-19) especially in those with severe infections after discharge from hospital. Moreover, no research had reported the health consequences in health care workers (HCWs) with COVID-19 after discharge. We aimed to investigate the health consequences in HCWs with severe COVID-19 after discharge from hospital in Hubei Province, China. Methods We conducted an ambidirectional cohort study in “Rehabilitation Care Project for Medical Staff Infected with COVID-19” in China. The participants were asked to complete three physical examinations (including the tests of functional fitness, antibodies to SARS-CoV-2 and immunological indicators) at 153.4 (143.3, 164.8), 244.3 (232.4, 259.1), and 329.4 (319.4, 339.3) days after discharge, respectively. Mann-Whitney U test, Kruskal-Wallis test, t test, one-way ANOVA, χ2, and Fisher’s exact test were used to assess the variance between two or more groups where appropriate. Results Of 333 HCWs with severe COVID-19, the HCWs’ median age was 36.0 (31.0, 43.0) years, 257 (77%) were female, and 191 (57%) were nurses. Our research found that 70.4% (114/162), 48.9% (67/137), and 29.6% (37/125) of the HCWs with severe COVID-19 were considered to have not recovered their functional fitness in the first, second, and third functional fitness tests, respectively. The HCWs showed improvement in muscle strength, flexibility, and agility/dynamic balance after discharge in follow-up visits. The seropositivity of IgM (17.0% vs. 6.6%) and median titres of IgM (3.0 vs. 1.4) and IgG (60.3 vs. 45.3) in the third physical examination was higher than that in the first physical examination. In the third physical examination, there still were 42.1% and 45.9% of the HCWs had elevated levels of IL-6 and TNF-α, and 11.9% and 6.3% of the HCWs had decreased relative numbers of CD3+ T cells and CD4+ T cells. Conclusion The HCWs with severe COVID-19 showed improvement in functional fitness within 1 year after discharge, active intervention should be applied to help their recovery if necessary. It is of vital significance to continue monitoring the functional fitness, antibodies to SARS-CoV-2 and immunological indicators after 1 year of discharge from hospital in HCWs with severe COVID-19.

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 .…”

Long-Term Effects of COVID-19 on Health Care Workers 1-Year Post-Discharge in Wuhan

“…To date, the project has carried out follow-up studies up to 1 year after discharge. The assessed variables include: organ impairment, persistent symptoms, psychological problems, physical examinations, and consultation with academicians [ 19 ]. In this study, HCWs with mild or severe COVID-19 in Wuhan, China, who were discharged from the hospital 1 year prior to this study were invited to participate.…”

Recovery of functional fitness, lung function, and immune function in healthcare workers with nonsevere and severe COVID-19 at 13 months after discharge from the hospital: a prospective cohort study

“…The participants were from the "Rehabilitation Care Project for Medical Staff Infected with COVID-19" in China, it was launched by the Chinese Academy of Engineering and Tencent Charity Foundation (Xiong et al, 2021). The participants were HCWs with COVID-19 in Hubei Province (including the provincial capital city Wuhan and its surrounding cities).…”

“…A study in China followed HCWs with COVID-19 for 3 months after discharge, it suggested that 69 (91%) of the HCWs with COVID-19 had returned to their original work, 82% of the HCWs' lung HRCTs returned to normal, and 42% of the HCWs had mild pulmonary function abnormalities (Liang et al, 2020). Our previous study reported dynamic changes of functional fitness and immunological indicators within 1 year after discharge in HCWs with severe COVID-19 (Xiong et al, 2021). There were also other studies revealing recovery of functional fitness (Paz et al,7 2021), lung function (Huang et al, 2021) and immune function (Qin et al, 2020;Wan et al, 2020) in patients with COVID-19.…”