Clinical and Laboratory Follow-up After Hospitalization for COVID-19 at an Italian Tertiary Care Center

Spinicci, Michele; Vellere, Iacopo; Graziani, Lucia; Tilli, Marta; Borchi, Beatrice; Mencarini, Jessica; Campolmi, Irene; Gori, Leonardo; Rasero, Laura; Fattirolli, Francesco; Olivotto, Iacopo; Lavorini, Federico; Marchionni, Niccolò; Zammarchi, Lorenzo; Bartoloni, Alessandro; Fumagalli, Carlo; Silverii, Maria Vittoria; Ciani, Luca; Zocchi, Chiara; Tassetti, Luigi; Marcucci, Rossella; Giusti, Betti; Livi, Luca; Giovannoni, Lorenzo; Parronchi, Paola; Almerigogna, Fabio; Annunziato, Francesco; Mazzoni, Alessio; Maggi, Laura; Liotta, Francesco; Cosmi, Lorenzo; Vultaggio, Alessandra; Matucci, Andrea; Sticci, Silvia; Donati, Maria Carla; Defraia, Cecilia; Giansanti, Fabrizio; Bacherini, Daniela

doi:10.1093/ofid/ofab049

Cited by 15 publications

(31 citation statements)

References 17 publications

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“…In our study, the frequency of re-admissions before the follow-up visit was 10.2 per cent, mainly for pneumonia, and/or respiratory failure. Similar re-hospitalization rates have been described by other researchers [ 6 , 7 ].…”

Section: Discussionsupporting

confidence: 90%

“…The most common symptoms were fatigue (42.4%) and dyspnea (37.3%). Similar data were recently reported by four studies evaluating COVID-19 patients 60 [ 6 , 7 ], 90 [ 8 ], and 110 days [ 9 ] after hospital discharge and by a large Chinese study performed 6 months after hospital discharge [ 10 ]. Our data suggest that COVID-19 has a significant impact on patient mental well-being.…”

Section: Discussionsupporting

confidence: 87%

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COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge

et al. 2021

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Purpose Few data are currently available on persistent symptoms and late organ damage in patients who have suffered from COVID-19. This prospective study aimed to evaluate the results of a follow-up program for patients discharged from a nonintensive COVID-19 ward. Methods 3–6 months after hospital discharge, 59 of 105 COVID-19 patients (31 males, aged 68.2 ± 12.8 years) were recruited in the study. Forty-six patients were excluded because of nontraceability, refusal, or inability to provide informed consent. The follow-up consisted of anamnesis (including a structured questionnaire), physical examination, blood tests, ECG, lower limb compression venous ultrasound (US), thoracic US, and spirometry with diffusion lung capacity for carbon monoxide (DLCO). Results 22% of patients reported no residual symptoms, 28.8% 1 or 2 symptoms and 49.2% 3 or more symptoms. The most frequently symptoms were fatigue, exertional dyspnea, insomnia, and anxiety. Among the inflammatory and coagulation parameters, only the median value of fibrinogen was slightly above normal. A deep vein thrombosis was detected in 1 patient (1.7%). Thoracic US detected mild pulmonary changes in 15 patients (25.4%), 10 of which reported exertional dyspnea. DLCO was mildly or moderately reduced in 19 patients (37.2%), 13 of which complained of exertional dyspnea. Conclusion These results highlight that a substantial percentage of COVID-19 patients (77.8%) continue to complain of symptoms 3–6 months after hospital discharge. Exertional dyspnea was significantly associated with the persistence of lung US abnormalities and diffusing capacity alterations. Extended follow-up is required to assess the long-term evolution of postacute sequelae of COVID-19.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 87%

COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge

et al. 2021

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“…The majority of patients testing positive for COVID-19 will not require hospital admission [67] and indeed persisting symptoms may occur in this group too with 47% of women and 33% of men having ≥1 symptom an average of 117 days post COVID-19 infection. [68] In our study between 8% to 28% of patients were re-hospitalised [25, 29, 38, 49, 50, 53] and 61.7% and 66.4% had visited their GP at the time of follow up [38, 50]. Up to 6 months after testing positive for COVID-19, 73% of non-hospitalised patients had visited their GP, a hospital outpatient clinic or been admitted to hospital.…”

Section: Discussionmentioning

confidence: 82%

“…Six studies reported on reattendance to healthcare providers following discharge. [25, 29, 38, 49, 50, 53] Rehospitalisation rate ranged from 8% to 28% at the time of follow-up across the 6 studies. Two studies found that 61.7% and 66.4% of participants had visited a GP between discharge and follow-up [38, 50] and 20.3% of participants had attended an emergency department by 3 months follow-up.…”

Section: Resultsmentioning

confidence: 99%

Patient-reported respiratory outcome measures in the recovery of adults hospitalised with COVID-19: A systematic review and meta-analysis

Middleton

Chalitsios

McKeever

et al. 2022

Preprint

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Background Acute COVID-19 clinical symptoms have been clearly documented, but long-term functional and symptomatic recovery from COVID -19 is less well described. Methods A systematic review and meta-analysis were conducted to describe patient-reported outcome measures (PROMs) in adults at least 8 weeks post hospital discharge for COVID-19. Comprehensive database searches in accordance with the PRISMA statement were carried out up till 31/05/2021. Data were narratively synthesized, and a series of meta-analyses were performed using the random-effects inverse variance method. Results From 49 studies, across 14 countries with between 2-12 months follow up, the most common persisting symptom reported was fatigue with meta-analysis finding 36.6% (95 % CI 27.6 to 46.6, n=14) reporting it at 2-4 months, decreasing slightly to 32.5% still reporting it at >4 months (95% CI 22.6 to 44.2, n=15). This was followed by dyspnoea. Modified MRC score (mMRC) ≥1 was reported in 48% (95% CI 30 to 37, n=5) at 2-4months reducing to 32% (95% CI 22 to 43, n=7) at 4 months. Quality of life (QOL) as assessed by the EQ-5D-5L VAS remained reduced at >4 months (73.6 95% CI 68.1 to 79.1, n=6). Hospitalisation with COVID-19 also resulted in persisting sick leave, change in scope of work, and continued use of primary and secondary healthcare. Conclusion The symptomatic and functional impact of COVID-19 continues to be felt by patients months after discharge from hospital. This widespread morbidity points towards a multi-disciplinary approach to aid functional recovery.

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“…On the other hand, a follow-up study of Spinicci et al [37] indicated that symptom persistence after 60 days from hospital discharge was not related to disease severity (83% in mild/moderate vs 85% in severe/critical, P = 0.807) and ICU admission (84% in ICU vs 84% in non-ICU, P = 0.981). Gautam et al [55] followed up COVID-19 patients admitted to hospital ward and intensive treatment unit (ITU) for 4-7 months from disease onset.…”

Section: Disease Severitymentioning

confidence: 96%

Persistent Gustatory Dysfunction in COVID-19 Survivors: A Narrative Literature Review

Tsuchiya

2021

JAMMR

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Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibit a diverse spectrum of clinical manifestations, some of which last for a long time, making a great impact on the healthcare of patients who recovered from coronavirus disease 2019 (COVID-19). Although taste disorders have been well-recognized to be closely associated with COVID-19, understanding of gustatory sequelae is relatively poor compared with oral symptoms in the early phase of COVID-19. The aim of this study was to characterize gustatory dysfunction in COVID-19 survivors by a narrative literature review of follow-up studies and to speculate the pathogenic mechanisms underlying such a persistent symptom. Scientific articles were retrieved by searching PubMed, LitCovid, ProQuest, medRxiv and bioRxiv from 1 April 2020 with a cut-off date of 10 September 2021. The follow-up time periods of the relevant 49 studies ranged from 4 weeks to 12 months. Results of the literature search indicated that ageusia, hypogeusia and/or dysgeusia persist in up to 45.0% of COVID-19 survivors and that the prevalence of these taste impairments varies depending on ethnicity, age, gender and disease severity of patients. Gustatory dysfunction can be detected at high frequency even one year after symptom onset. Persistence of gustatory dysfunction is pathogenically related to expression of SARS-CoV-2 cellular entry-relevant receptors in taste cells and neural cells, decreased saliva secretion, zinc deficiency, disturbed nervous system and inflammation associated with persistent SARS-CoV-2 infection. Given the long-term persistence of gustatory dysfunction in COVID-19 survivors, their discharge from hospital is not the end of disease. Careful attention should be continuously paid to taste perception of post-COVID-19 patients to recover the health-relating quality of life, which is required for health providers, especially dental professionals who not only may experience COVID-19 survivors but also can easily become aware of their taste abnormalities.

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Clinical and Laboratory Follow-up After Hospitalization for COVID-19 at an Italian Tertiary Care Center

Cited by 15 publications

References 17 publications

COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge

COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge

Patient-reported respiratory outcome measures in the recovery of adults hospitalised with COVID-19: A systematic review and meta-analysis

Persistent Gustatory Dysfunction in COVID-19 Survivors: A Narrative Literature Review

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