Long COVID-19 Syndrome Severity According to Sex, Time from the Onset of the Disease, and Exercise Capacity—The Results of a Cross-Sectional Study

Abstract

Symptoms of long COVID-19 syndrome (long COVID-19) are reported by 80% of convalescents up to several months after contracting the coronavirus-19 disease (COVID-19). The study aimed to assess the frequency and correlations of long COVID symptoms with sex, disease severity, time since the onset of the disease, and exercise capacity in a population of Polish convalescents hospitalized as a part of a rehabilitation program after COVID-19. The retrospective analysis was carried out based on medical records concerning reported symptoms, comorbidities, exercise capacity, fatigue and dyspnea on Borg’s scale, arterial oxygen saturation (SpO2), spirometric parameters, chest X-rays/computed tomography scans, systolic pulmonary artery pressure, and left ventricular ejection fraction. The study involved 471 patients aged 63.83 ± 9.93 years who had been hospitalized 191.32 ± 75.69 days from the onset of COVID-19, of which 269 (57.1%) were women. The most common symptoms were fatigue (99.57%), dyspnea (99.36%), and myalgia (97.03%). Women reported more symptoms than men (p < 0.001) and rated their fatigue as more severe (p = 0.021). Patients with depressed moods reported more physical symptoms than others (p < 0.001). Most long COVID symptoms, including dyspnea, fatigue, and depressive symptoms, were found with the same frequency in patients 12–24 weeks and >24 weeks after recovery (p = 0.874, p = 0.400, and p = 0.320, respectively), regardless of acute COVID-19 severity (p = 0.240, p = 0.826, and p = 0.108, respectively). Dyspnea severity correlated with forced vital capacity (FVC) (r = −0.153, p = 0.005), and forced expiratory volume in one second (FEV1) (r = −0.142, p = 0.008). Fatigue severity correlated with impaired FVC and FEV1 (both r = −0.162, p = 0.003). Fatigue and dyspnea inversely correlated with the distance in a six-minute walk test (r = −0.497, p < 0.001, and r = −0.327, p < 0.001). In conclusion, in our cohort, long COVID symptoms are more common in women. Dyspnea/fatigue and depressive symptoms do not tend to subside after an average six-month recovery period. The intensity of perceived fatigue may be exaggerated by the coexistence of neuropsychiatric disorders. Increased fatigue and dyspnea correlate with impaired spirometric parameters and significantly affects convalescents’ exercise capacity.

Post-COVID-19 syndrome: Physical capacity, fatigue and quality of life

“…As in other studies, our patient population showed a reduced VO2 max as well as a reduced walking distance in the 6MWT [27][28][29]. The performance in percentage was more limited in the maximal ranges than in the submaximal range, although the FAS correlated significantly only with the 6MWT performance, a finding also observed in other studies [6], and tended to correlate with VO2 max . Possible causes of impaired cardiopulmonary fitness can be, in addition to reduced fitness even before the onset of the disease, a further reduction due to inactivity and a sedentary lifestyle because of COVID-19 related symptoms [29] or government-ordered measures of quarantine [30,31].…”

“…Approximately 80% of hospitalized and non-hospitalized patients have symptoms lasting longer than 12 months [3]. Important risk factors associated with PCS appears to be pre-existing illnesses (especially cardiorespiratory, autoimmune and oncological previous diseases, and neuropsychiatric disorders), female gender, respiratory symptoms at onset, length of hospital stay and severity of illness, although milder courses also can trigger PCS [1,[4][5][6]. The most common symptoms that contribute mainly to decreased health recovery and reduced resilience include fatigue, reduced exercise tolerance and muscular strength, neurocognitive problems, muscle pain and dyspnea [7,8].…”

Functional Status in Older Adults following Hospitalization for COVID-19: A Cohort Study

“…These findings are consistent with those of previous studies. [16][17][18][19] Moreover, our analyses showed that admission was associated with increased functional limitations and/or mortality after discharge. Previous studies described functional impairments following ICU admission owing to COVID-19 and other critical illnesses.…”

Pathological Interplay and Clinical Complications between COVID-19 and Cardiovascular Diseases: An Overview in 2023

“…We found that depression is widespread in patients have survived COVID-19, especially in women, and often co-exists with fatigue, dyspnea, and cognitive dysfunction, affecting patients’ quality of life [62, 63]. Therefore, psychological support and psychiatric intervention should be considered during the process of cardiac rehabilitation (Fig.…”