“Long COVID” follow-up pathway: results of longitudinal cohort study to investigate 6- and 12-month outcomes after hospitalization for SARS-CoV-2 infection

Abstract

Long-term sequelae of symptomatic infection caused by SARS-CoV-2 are largely undiscovered. We performed a prospective cohort study on consecutively hospitalized Sars-CoV-2 patients (March-May 2020) for evaluating COVID-19 outcomes at 6 and 12 months. After hospital discharge, patients were addressed to two follow-up pathways based on respiratory support needed during hospitalization. Outcomes were assessed by telephone consultation or ambulatory visit. Among 471 patients, 81.6% received no respiratory support during hospitalization; 8.2% received non-invasive ventilation; 0.2% required invasive mechanical ventilation (IMV). 64 patients died during hospitalization, therefore 407 were enrolled for follow-up. At 6 months, among 355patients, the 27.0% had any symptoms, 19.4% dyspnea, 5.4% neurological symptoms. Fifty-two out of 104 had major damages in interstitial Computed Tomography images. IMV patients had higher probability to suffer of neurological symptoms (OR=4.12, p=0.01). At 12 months, among 344, the 24.4% suffered on any symptoms, 14.0% dyspnea, 10.0% neurological symptoms. Severe interstitial lesions were present in 37 out of 47 investigated patients. IMV patients in respect to no respiratory support, had higher probability of experiencing symptoms (OR=3.51, p<0.01), dyspnea (OR=3.08, p<0.01 ), neurological symptoms (OR= 11.50, p<0.01). COVID-19 patients showed prolonged sequelae up to 12 months, highlighting the need of follow-up pathways for post-COVID-19 syndrome.