Patient-Reported Experiences of Persistent Post–COVID-19 Conditions After Hospital Discharge During the Second and Third Waves of the Pandemic in Switzerland: Cross-Sectional Questionnaire Study (Preprint)

Abstract

BACKGROUND Hospitalized patients infected with SARS-CoV-2 should recover within a few weeks. However, even those with mild versions can have signs and symptoms that last four weeks or longer. These post-COVID conditions (PCCs) comprise various new, returning, or ongoing conditions and symptoms that can last months, years, or cause disability. OBJECTIVE Investigate self-reported, persistent PCCs among patients discharged during the pandemic’s second and third waves. METHODS Following a literature review, an ad hoc questionnaire on PCCs was designed, pretested on four discharged patients, and sent to all eligible inpatients discharged between October 2020 and April 2021. At 4–6 months after discharge, we collected data on PCCs and scores for the Multidimensional Fatigue Inventory (MFI), the Patient Health Questionnaire-4 (PHQ-4), a Brief Memory Screening Scale (Q3PC), and a post-traumatic stress disorder scale (PCL-5). Descriptive, inferential, and multivariate linear regression statistics were computed to assess PCC symptomatology, associations, and differences regarding sociodemographic characteristics and hospital length of stay (LOS). RESULTS Of 1994 valid questionnaires, 1749 were returned by non-infected patients and 245 were returned by SARS-CoV-2-positive patients. The overall sample’s median age was 64 (62 and 71 for the non-infected and infected, respectively). Only 28.2% of SARS-CoV-2 infected respondents were symptom-free after 4–6 months. Significant differences were found between men’s and women’s numbers of PCC symptoms (p=.003) and LOS (p>.001). No significant differences were found between age groups (p=.500) and hospitalization units (p=.092). Significant differences were found between the self-reported PHQ-4 scores during the hospitalization and four months after (p<.001), with higher scores among hospitalized patients. Three-quarters (76.4%) of the respondents affected by COVID-19 reported memory loss and concentration disorders (Q3PC). No significant differences regarding the median MFI score of 56 were found in the sociodemographic variables. Significant differences were found between the median PCL-5 score and LOS, with higher scores among respondents with longer stays (p = .009). Multivariate linear regression allowed us to calculate that the combination of PHQ-4, Q3PC, and PCL-5 scores, adjusted for age, sex, and LOS, did not significantly predict MFI scores (R2 = 0.093 (F (3/197) = 1.500; p = .216 adjusted R2 = .061.). CONCLUSIONS The majority of inpatients infected with SARS-CoV-2 presented with PCCs at 4–6 months after discharge, with complex clinical pictures. Only one-third of those infected were symptom-free during that time. More research is needed to explore PCCs based on the self-reported health experiences of discharged inpatients who have been infected by SARS-CoV-2. CLINICALTRIAL not applicable