Three-Month Follow-Up Study of Survivors of Coronavirus Disease 2019 after Discharge

Abstract

Background: Most patients including health care workers (HCWs) survived the coronavirus disease 2019 (COVID-19), however, knowledge about the sequelae of COVID-19 after discharge remains limited. Methods: A prospectively observational 3-month follow-up study evaluated symptoms, dynamic changes of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) IgG and IgM, lung function, and high resolution computed tomography (HRCT) of survivors of COVID-19 after discharge at Wuhan Union Hospital, China. Results: Seventy-six survivors (55 females) with a mean age of 41.3 ± 13.8 years were enrolled, and 65 (86%) were HCWs. A total of 69 (91%) patients had returned to their original work at 3-months after discharge. Most of the survivors had symptoms including fever, sputum production, fatigue, diarrhea, dyspnea, cough, chest tightness on exertion and palpitations in the three months after discharge. The serum troponin-I levels during the acute illness showed high correlation with the symptom of fatigue after hospital discharge (r = 0.782; P = 0.008) and lymphopenia was correlated with the symptoms of chest tightness and palpitations on exertion of patients after hospital discharge (r = −0.285, P = 0.027; r = −0.363, P = 0.004, respectively). The mean values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, total lung capacity and diffusion capacity were all normal (> 80% predicted) and lung HRCTs returned to normal in most of the patients (82%), however, 42% of survivors had mild pulmonary function abnormalities at 3-months after discharge. SARS-CoV-2 IgG turned negative in 11% (6 of 57 patients), 8% (4 of 52 patients) and 13% (7 of 55 patients), and SARS-CoV-2 IgM turned negative in 72% (41 of 57 patients), 85% (44 of 52 patients) and 87% (48 of 55 patients) at 1-month, 2-months and 3-months after discharge, respectively. Conclusion: Infection by SARS-CoV-2 caused some mild impairments of survivors within the first three months of their discharge and the duration of SARS-CoV-2 antibody was limited, which indicates the necessity of long-term follow-up of survivors of COVID-19.

Prevalence and Determinants of Fatigue after COVID-19 in Non-Hospitalized Subjects: A Population-Based Study

“…A few other studies have used single items to assess fatigue following COVID-19, generally reporting higher prevalence of fatigue than in our study [ 12 , 13 , 14 , 32 ]. However, differences in populations, methods, and timing relative to the acute phase complicates comparisons between studies.…”

“…There is considerable concern about long-term sequelae following COVID-19 and that the disease will trigger post-viral fatigue syndromes [ 8 , 9 , 10 , 11 ]. The prevalence of fatigue following hospitalization for COVID-19 ranges from 52 to 70% at 1–3 months after hospital discharge [ 12 , 13 , 14 ]. Although non-hospitalized patients represent a larger patient group, the majority of emerging data concerns hospitalized patients.…”

Radiological and functional lung sequelae of COVID-19: a systematic review and meta-analysis

“…The decision to discharge was made clinically based on patients’ clinical status and per hospital policy in the other 12 studies [ 20 – 31 ]. Among these studies, 13 studies collected data of chest CT [ 17 – 25 , 27 , 29 – 31 ] and 10 studies collected data of PFT [ 17 , 18 , 20 , 22 , 24 – 29 ] from the patients with COVID-19 discharged during their study period. Risk of bias of each study is shown in Additional file 1 : figure S2.…”

“…We identified 10 studies regarding PFT results in follow up period after 1 month [ 17 , 18 , 20 , 22 , 24 – 29 ]. The follow-up timing was approximately 90 days on average.…”

COVID‐19: Current knowledge in clinical features, immunological responses, and vaccine development

“…145 Furthermore, a prospective observational 3-month follow-up study found that although lung high-resolution computed tomography (HRCT) returned to normal in most of the patients, in 42% of them mild pulmonary abnormalities persisted and 50% suffered from symptoms such as dyspnea, cough, chest tightness, and palpitations on exertion 3 months after discharge. 146 Another study has reported that 35 out of 55 recovered participants exhibited different degrees of radiological abnormalities 3 months after discharge. 147 In some follow-up patients, lung interstitial thickening and pure ground-glass opacity were among the most common features on HRCT scans.…”