Post discharge persistent symptoms after COVID-19 in rheumatic and musculoskeletal diseases

Abstract

OBJECTIVES: To describe persistent symptoms and consequences in Rheumatic and Musculoskeletal diseases (RMD) discharged from the hospital after Covid-19; to assess the roll of autoimmune rheumatic diseases (ARD) compared to and non-autoimmune rheumatic and musculoskeletal diseases (NARD) on persistent symptoms and consequences. METHODS: We performed a cross-sectional observational study. RMD attended at a rheumatology outpatient clinic in Madrid with Covid-19 that required hospital admission were included. The main outcomes were persistence of symptoms and health consequences related to Covid19 after discharge. Independent variable was RMD group (ARD and NARD) and covariates were sociodemographic, clinical, and treatments. We ran a multivariable logistic regression model to assess the risk by RMD group on main outcomes. RESULTS: We included 105 patients and 51.5% had ARD. 68.57% reported at least one persistent symptom. The most frequent were dyspnea, fatigue, and chest pain. 31 patients had consequences. Lung damage was found in 11.4% of the patients, 18% had blood test abnormalities (10% lymphopenia), two died, one developed central retinal vein occlusion and one patient developed optic neuritis. 11 patients required readmission due to Covid-19 problems (16.7% ARD vs 3.9% NARD; p=0.053). No statistically significant differences by RMD groups were found in the final models. CONCLUSION: Many RMD patients have persistent symptoms, similar to other populations. This study also highlights that lung damage is the most frequent consequence. ARD compared to NARD does not seem to differ in terms of persistent symptoms or consequences, although ARD might have a greater number of readmissions due to Covid-19.

Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis

“…In the manual search of gray literature and preprints, 18 potentially related papers were included. After reviewing the titles and abstracts of the articles, 157 peer-reviewed papers or preprinted manuscripts were reviewed and a total of 91 articles were entered into the present meta-analysis [ 8 , [14] , [15] , [16] , [17] , [18] , [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] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] ,…”

DMARD disruption, disease flare, and prolonged symptom duration after acute COVID-19 among participants with rheumatic disease: A prospective study

“…Global patient-reported disease activity was worse at the time of survey than before COVID-19 (mean 6.6±2.9 vs. 7.6±2.3, p<0.001). Median time to COVID-19 symptom resolution was 14 days (IQR 9,29).…”

“…An early study surveyed 105 rheumatology participants in Spain who had been hospitalized with COVID-19 and classified them as having SARDs (n=54) or non-autoimmune rheumatic conditions (n=51, such as osteoarthritis)(29). Similar to our study, they found that a high proportion of subjects had lingering symptoms (some lasting for over 90 days) that included dyspnea, fatigue, chest pain, and cough.…”

“…Global patient-reported disease activity was worse at the time of survey than before COVID-19 (mean 6.6±2.9 vs. 7.6±2.3, p<0.001). Median time to COVID-19 symptom resolution was 14 days (IQR 9,29).Prolonged symptom duration of ≥28 days occurred in 45%. Hospitalization for COVID-19 (OR 3.54, 95%CI 1.27-9.87) and initial COVID-19 symptom count (OR 1.38 per symptom, 95%CI 1.17-1.63) were associated with prolonged symptom duration.…”

Impact of vaccination on post-acute sequelae of SARS CoV-2 infection in patients with rheumatic diseases

“…The etiology of PASC remains unknown but several factors have been hypothesized to influence risk, including alterations in inflammatory cytokine profiles, cellular immune responses, reactivation of chronic viral infections, and autoantibody formation. [35][36][37][38][39][40][41] Vaccination may reduce the risk of PASC by shortening the duration of viremia, reducing the risk of severe COVID-19 and the associated hyperinflammatory state, influencing the cellular immune response to acute infection, among other possible explanations.…”