Long COVID 12 months after discharge: persistent symptoms in patients hospitalised due to COVID-19 and patients hospitalised due to other causes—a multicentre cohort study

Abstract

Background Long-term-specific sequelae or persistent symptoms (SPS) after hospitalisation due to COVID-19 are not known. The aim of this study was to explore the presence of SPS 12 months after discharge in survivors hospitalised due to COVID-19 and compare it with survivors hospitalised due to other causes. Methods Prospective cohort study, the Andalusian Cohort of Hospitalised patients for COVID-19 (ANCOHVID study), conducted in 4 hospitals and 29 primary care centres in Andalusia, Spain. The sample was composed of 906 adult patients; 453 patients hospitalised due to COVID-19 (exposed) and 453 hospitalised due to other causes (non-exposed) from March 1 to April 15, 2020, and discharged alive. The main outcomes were (1) the prevalence of SPS at 12 months after discharge and (2) the incidence of SPS after discharge. Outcome data at 12 months were compared between the exposed and non-exposed cohorts. Risk ratios were calculated, and bivariate analyses were performed. Results A total of 163 (36.1%) and 160 (35.3%) patients of the exposed and non-exposed cohorts, respectively, showed at least one SPS at 12 months after discharge. The SPS with higher prevalence in the subgroup of patients hospitalised due to COVID-19 12 months after discharge were persistent pharyngeal symptoms (p<0.001), neurological SPS (p=0.049), confusion or memory loss (p=0.043), thrombotic events (p=0.025) and anxiety (p=0.046). The incidence of SPS was higher for the exposed cohort regarding pharyngeal symptoms (risk ratio, 8.00; 95% CI, 1.85 to 36.12), confusion or memory loss (risk ratio, 3.50; 95% CI, 1.16 to 10.55) and anxiety symptoms (risk ratio, 2.36; 95% CI, 1.28 to 4.34). Conclusions There was a similar frequency of long-term SPS after discharge at 12 months, regardless of the cause of admission (COVID-19 or other causes). Nevertheless, some symptoms that were found to be more associated with COVID-19, such as memory loss or anxiety, merit further investigation. These results should guide future follow-up of COVID-19 patients after hospital discharge.

Increased risk of new‐onset cardiovascular disease after COVID‐19: A systematic review and meta‐analysis of 14 cohorts

“…Table 1 and Appendix Table present the baseline characteristics of the included studies, Appendix Table presents the potential confounding variables adjusted or matched in included cohorts, and Appendix Table presents the funding sources of included studies. Overall, participants were from nine countries, seven of 14 studies were conducted in the United States, 29,31–33,36–38 two in the United Kingdom, 11,35 two in Spain, 12,30 and the remaining three were in Sweden, 39 Netherlands, 40 and global (France, Germany, Italy, Singapore, U.S.), 34 respectively. With 69.6% were white people (interquartile range [IQR]: 55.7–74.3), and the median mean age was 48.8 years (IQR: 42.4–63.4).…”

“…Finally, the certainty of evidence was assessed and categorised as high, moderate, low, or very low. Overall, participants were from nine countries, seven of 14 studies were conducted in the United States, 29,[31][32][33][36][37][38] two in the United Kingdom, 11,35 two in Spain, 12,30 and the remaining three were in Sweden, 39 Netherlands, 40 and global (France, Germany, Italy, Singapore, U.S.), 34 respectively. With 69.6% were white people…”

“…COVID-19 itself may cause a wide spectrum of potential myocardial involvement, and lead to cardiovascular complications, which may range from myocardial infarction, heart failure, arrhythmias, and even coagulation abnormalities. [10][11][12] Studies have found that the SARS-CoV-2 virus may linger damage from direct viral invasion of cardiomyocytes and trigger an inflammatory response, leading to complications such as myocarditis and myocardial damage after infection. [13][14][15] In addition, COVID-19 is also associated with an increased risk of thrombosis, which may lead to cardiovascular and cerebrovascular accidents.…”

“…On the other hand, cardiac involvement acts as a possible late phenomenon of the viral respiratory infection. COVID‐19 itself may cause a wide spectrum of potential myocardial involvement, and lead to cardiovascular complications, which may range from myocardial infarction, heart failure, arrhythmias, and even coagulation abnormalities 10–12 . Studies have found that the SARS‐CoV‐2 virus may linger damage from direct viral invasion of cardiomyocytes and trigger an inflammatory response, leading to complications such as myocarditis and myocardial damage after infection 13–15 .…”

“…Following the screening of titles and abstracts, 160 studies were identified as potentially eligible and underwent full-text review. Eventually, 14 studies, involving a total of 25,378,834 participants11,12,[29][30][31][32][33][34][35][36][37][38][39][40] proved eligible (Figure1). The list of excluded studies can be found in Appendix TableS4.…”