Short-Term Consequences of SARS-CoV-2-Related Pneumonia: A Follow Up Study

Abstract

The aim of the study was to assess the short-term consequences of SARS-CoV-2-related pneumonia, also in relation to radiologic/laboratory/clinical indices of risk at baseline. This prospective follow-up cohort study included 94 patients with confirmed COVID-19 admitted to a medical ward at the Montichiari Hospital, Brescia, Italy from February 28th to April 30th, 2020. Patients had COVID-19 related pneumonia with respiratory failure. Ninety-four patients out of 193 survivors accepted to be re-evaluated after discharge, on average after 4 months. In ¼ of the patients an evidence of pulmonary fibrosis was detected, as indicated by an altered diffusing capacity of the lung for carbon monoxide (DLCO); in 6–7% of patients the alteration was classified as of moderate/severe degree. We also evaluated quality of life thorough a structured questionnaire: 52% of the patients still lamented fatigue, 36% effort dyspnea, 10% anorexia, 14% dysgeusia or anosmia, 31% insomnia and 21% anxiety. Finally, we evaluated three prognostic indices (the Brixia radiologic score, the Charlson Comorbidity Index and the 4C mortality score) in terms of prediction of the clinical consequences of the disease. All of them significantly predicted the extent of short-term lung involvement. In conclusion, our study demonstrated that SARS-CoV-2-related pneumonia is associated to relevant short-term clinical consequences, both in terms of persistence of symptoms and in terms of impairment of DLCO (indicator of a possible development of pulmonary fibrosis); some severity indices of the disease may predict short-term clinical outcome. Further studies are needed to ascertain whether such manifestations may persist long-term.

Psychiatric and neuropsychiatric sequelae of COVID-19 – A systematic review

“…Fatigue following recovery from acute COVID-19 was reported in 32 studies ( Al-Aly et al, 2021 , Albu et al, 2021 , Augustin et al, 2021 , Boari et al, 2021 , Chevinsky et al, 2021 , D'Cruz et al, 2021 , Daher et al, 2020 , Darley et al, 2021 , Daugherty et al, 2021 , Frontera et al, 2021 , Gautam et al, 2021 , Graham et al, 2021 , Halpin et al, 2021 , Huang et al, 2021a , Huang et al, 2021b , Iqbal et al, 2021 , Liang et al, 2020 , Morin et al, 2021 , Noviello et al, 2021 , Petersen et al, 2020 , Qu et al, 2021 , Romero-Duarte et al, 2021 , Sami et al, 2020 , Shang et al, 2021 , Sudre et al, 2021 , Sun et al, 2021 , Sykes et al, 2021 , Tenforde et al, 2020 , Townsend et al, 2020 , Townsend et al, 2021 , van den Borst et al, 2020 , Xiong et al, 2021 ). The results ranged from no fatigue at 1 month follow-up ( Huang et al, 2021b ) to 87% suffering from fatigue with 12 studies reporting >45% of their populations to be affected ( Albu et al, 2021 , Boari et al, 2021 , D'Cruz et al, 2021 , Daher et al, 2020 , Gautam et al, 2021 , Graham et al, 2021 , Halpin et al, 2021 , Huang et al, 2021a , Iqbal et al, 2021 , Liang et al, 2020 , Townsend et al, 2020 , van den Borst et al, 2020 ).…”

“…Sleep disturbances following COVID-19 was reported in 24 studies ( Al-Aly et al, 2021 , Boari et al, 2021 , D'Cruz et al, 2021 , De Lorenzo et al, 2020 , Frontera et al, 2021 , Gautam et al, 2021 , Gennaro et al, 2021 , Graham et al, 2021 , Huang et al, 2021a , Huang et al, 2021b , Iqbal et al, 2021 , Lorenzo et al, 2021 , Mazza et al, 2020 , Mazza et al, 2021 , Negrini et al, 2021 , Noviello et al, 2021 , Romero-Duarte et al, 2021 , Sami et al, 2020 , Shang et al, 2021 , Sykes et al, 2021 , Tanriverdi et al, 2021 , Taquet et al, 2021a , Taquet et al, 2021b , Wong et al, 2020 ). The results range from Noviello et al (2021) reporting no differences between COVID-19 survivors and controls at a 5 months follow-up to Graham et al (2021) , showing that 85% of the patients experienced sleep disturbances at 4–6 months follow-up.…”

“…The most frequently reported psychiatric deficits were depression and/or anxiety. In total, this was examined in 47 studies ( Al-Aly et al, 2021 , Alemanno et al, 2021 , Boari et al, 2021 , Chen et al, 2020 , Chevinsky et al, 2021 , Daher et al, 2020 , Darley et al, 2021 , Daugherty et al, 2021 , De Lorenzo et al, 2020 , Frontera et al, 2021 , Gennaro et al, 2021 , González et al, 2021 , Halpin et al, 2021 , Huang et al, 2021a , Iqbal et al, 2021 , Lorenzo et al, 2021 , Matalon et al, 2021 , Mattioli et al, 2021 , Mazza et al, 2020 , Mazza et al, 2021 , Méndez et al, 2021 , Monti et al, 2021 , Morin et al, 2021 , Negrini et al, 2021 , Noviello et al, 2021 , Ortelli et al, 2021 , Poyraz et al, 2021 , Romero-Duarte et al, 2021 , Sykes et al, 2021 , Tanriverdi et al, 2021 , Taquet et al, 2021a , Taquet et al, 2021b , Tomasoni et al, 2021 , Townsend et al, 2021 , van den Borst et al, 2020 , Venturelli et al, 2021 , Wang et al, 2020b , Wang et al, 2020c , Whiteside et al, 2021 , Wong et al, 2020 , Wu et al, 2020 , Xiong et al, 2021 , Yuan et al, 2020 , Zhou et al, 2020 , D'Cruz et al, 2021 , de Graaf et al, 2021 , Weerahandi et al, 2021 ). The results range from no indication of depression or anxiety ( Daher et al, 2020 , Zhou et al, 2020 ) to >30% at follow-up ( De Lorenzo et al, 2020 , Frontera et al, 2021 , Iqbal et al, 2...…”

“…Female sex was a risk factor Bellan et al, 2021 (Italy) To evaluate lung function, exercise function and psychological seuelae in COVID-19 patients Cohort study IES-R (self-rating) 238 142 (59.7%) 61 3–4 months after discharge Age >=18 years, discharged from hospital after admission for COVID-19 Not reported 42.8% of the patients showed PTS symptoms. Male sex was a risk factor for moderate to severe PTS Boari et al, 2021 (Italy) To assess short-term consequences of COVID-19 Prospective follow-up cohort study A structured questionnaire for fatigue, insomnia and anxiety 94 Not reported Not reported 4 months COVID-19 survivors with bilateral pulmonary interstitial opacities and ARDS Not reported At follow up 52% experienced fatigue, 31% insomnia and 21% anxiety Chen et al, 2020 (China) To survey health-related quality of life among COVID-19 patients 1 month after discharge compared to the general Chinese population Cohort study The Chinese version of the IQOLA SF-36 361 186 (51.5%) 47.2 1 month after discharge Cases: COVID-19 patients discharged from 1 of 12 hospitals in Wenzhou City. Controls: A random sample of Chinese adults Not reported The severity of the COVID-19 course was negatively associated with the physical functioning, general health, role limitation due to emotional problems, and mental health (p < 0.05).…”

Single-Dose Intranasal Administration of AdCOVID Elicits Systemic and Mucosal Immunity against SARS-CoV-2 and Fully Protects Mice from Lethal Challenge

“…Morbidity from SARS-CoV-2 infection can be severe, especially in high-risk groups (e.g., the elderly, individuals with chronic comorbidities such as hypertension, obesity, and diabetes) [ 4 ]. Evidence from convalescent COVID-19 patients and survivors of similar β-coronaviruses such as SARS-CoV and Middle East respiratory syndrome (MERS), suggests that COVID-19 survivors may suffer long-term sequelae (e.g., inflammation resulting in damage to the lungs and heart) [ 5 , 6 , 7 , 8 , 9 ]. The global impact on human health and well-being underscores the immediate need for safe and effective vaccines against SARS-CoV-2 to end this pandemic and prevent its return.…”