Persistent Health Problems beyond Pulmonary Recovery up to 6 Months after Hospitalization for COVID-19: A Longitudinal Study of Respiratory, Physical, and Psychological Outcomes

Abstract

Rationale: Data on longitudinal recovery after hospitalization for SARS-CoV-2 remain currently scarce, just as outcomes beyond 3 months follow-up. Objective:The aim of the study was to evaluate the sequelae up to 6 months after hospitalization for SARS-CoV-2 infection, considering 1) the recovery of pulmonary function and radiological abnormalities, physical and mental health status, and health-related quality of life (HR-QoL); and 2) the predictors of the most clinically relevant sequelae. Methods:Patients were evaluated at 6 weeks, 3 and 6 months after hospitalization with pulmonary function testing, radiological evaluation, and online questionnaires on physical and mental health status and HR-QoL. Outcomes were analyzed with repeated measurements analyses.Results: Ninety-two patients were included; mean age 58.2±12.3 years, and 58 (63.0%) males. The estimated percentage of patients with impaired FVC improved from 25% at 6 weeks to 11% at 6 months; for impaired diffusion capacity this percentage improved from 63% to 46%.. Radiologically ground glass decreased, but fibrosis persisted. The majority of patients (89.1%) still reported >1 symptom 6 months after discharge. Fatigue decreased significantly over time (p=0.006). Nonetheless, fatigue remained present in 51% of the patients at 6 months. HR-QoL (nearly) normalized in most domains at 6 months, except for physical role functioning, with persistent fatigue and length of hospitalization as most important predictors. Conclusions:During the first 6 months after hospitalization for SARS-CoV-2 most patients demonstrated continuing recovery across all health domains, but persistent sequelae were frequent.Fatigue was the most frequent residual and persisting symptom up to 6 months after hospitalization, importantly impacting HR-QoL.

The Impact of Long COVID-19 on Mental Health: Observational 6-Month Follow-Up Study

“…Whether PTSD is also highly prevalent in the aftermath of different COVID-19 populations remains to be determined. Previous published studies reported prevalences of symptoms of PTSD ranging from 10% to 30% in patients discharged from the hospital [5][6][7][8][9][10][11][12], which is lower than the current prevalence rates from hospitalized as well as nonhospitalized patients.…”

“…Accordingly, COVID-19 might also lead to PTSD. Indeed, previous studies reported prevalences of symptoms of PTSD ranging from 10% to 30% in patients discharged from the hospital [5][6][7][8][9][10][11][12]. Prevalences of symptoms of anxiety and depression in these samples vary between 5% and 42% [7,[9][10][11][12] and 14% and 31% [6,9,11,12], respectively.…”

“…Indeed, previous studies reported prevalences of symptoms of PTSD ranging from 10% to 30% in patients discharged from the hospital [5][6][7][8][9][10][11][12]. Prevalences of symptoms of anxiety and depression in these samples vary between 5% and 42% [7,[9][10][11][12] and 14% and 31% [6,9,11,12], respectively. A recently published review also confirmed the persistence of symptoms and their physical and psychosocial impact following a COVID-19 infection [13].…”

“…Hellemons and colleagues [12] reported an even lower prevalence for PTSD (4%) in patients with COVID-19 6 months after hospital discharge. With regards to anxiety and depression, a meta-analysis demonstrated pooled prevalences of 47% and 45% for anxiety and depression, respectively, in patients with COVID-19 [34].…”

Puzzling persisting symptoms after COVID-19

“…With more recent studies and longer-term follow-up data, however, it becomes increasingly clear that although pulmonary function impairment is common after hospitalisation for COVID-19, this gradually recovers towards normal values up to 1 year after discharge [ 9 , 10 ]. Likewise, radiological abnormalities gradually improve over time and are rarely severe [ 11 ].…”