Remote Assessment of Quality of Life and Functional Exercise Capacity in a Cohort of COVID-19 Patients One Year after Hospitalization (TELECOVID)

Abstract

Studies have reported persistent symptoms in patients hospitalized for COVID-19 up to 6 months post-discharge; however, sequalae beyond 6 months are unknown. This study aimed to investigate the clinical status of COVID-19 patients one year after hospital discharge and describe the factors related to poor outcomes. We conducted a single-center, prospective, cohort study of patients in Le Havre hospital (France) between 1 March 2020 and 11 May 2020. Baseline characteristics were collected from medical charts (including KATZ index and Clinical Frailty scale (CFS)), and a remote assessment was conducted 12 months after discharge. The main outcomes were the scores of the physical and mental components (PCS and MCS) of the Short-Form 36 (SF-36) and performance on the one-minute sit-to-stand test (STST1′). Scores <50% of the predicted values were considered as poor, and univariate and multivariate analyses were undertaken to investigate factors related to poor outcomes. Remote assessment was performed for 128 of the 157 (82%) eligible patients. Twenty-two patients were admitted to the intensive care unit (ICU), 45 to the intermediate care unit (IU), and 61 to the general ward (GW). Patients who spent time in ICU were more independent and younger. A large proportion of the sample had poor physical (30%) and mental health (27%) and a poor functional exercise capacity (33%) at the remote assessment. Higher levels of frailty at admission and hospital discharge were, respectively, associated with a higher risk of poor functional exercise capacity (StdOR 3.64 (95%CI 1.39–10.72); p = 0.01) and a higher risk of poor mental health (StdOR 2.81 (95%CI 1.17–7.45); p = 0.03). Long-term outcomes following hospitalization for COVID-19 infection may be negative for at least one year after discharge. Remote follow-up assessment could be highly beneficial for COVID-19 patients.

Long COVID and hypertension-related disorders: a report from the Japanese Society of Hypertension Project Team on COVID-19

“…CFS-based frailty predicted late mortality more strongly than the severity of COVID-19 [ 164 ]. Frailty was also associated with poor mental health [ 165 ], poor exercise capacity [ 166 ], reduced quality of life [ 167 ], and sustained symptom of COVID-19 [ 168 ]. Conversely, COVID-19 is reported to increase the risk of frailty [ 169 – 172 ].…”

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.…”

Long-term Health-related Quality of Life and Physical Function of COVID-19 Survivors with ICU-acquired Weakness

“…In addition, Combret et al. 31 ) reported that frailty at admission is associated with low MCS scores 1 year after hospitalization for COVID-19. The inclusion of patients limited to those under the age of 75 years who were independent in ADL before admission, along with the lower proportion of females, may have influenced the results in this study.…”

“…28,29) In a study of COVID-19 patients with sequelae lasting more than 4 weeks after onset, Poudel et al 30) reported that being female was a significant determinant associated with an MCS score below 50 on the SF-36. In addition, Combret et al 31) reported that frailty at admission is associated with low MCS scores 1 year after hospitalization for COVID-19. The inclusion of patients limited to those under the age of 75 years who were independent in ADL before admission, along with the lower proportion of females, may have influenced the results in this study.…”