Long-Term Effects of COVID-19 on Health Care Workers 1-Year Post-Discharge in Wuhan

Abstract

Introduction To assess the long-term consequences of coronavirus disease (COVID-19) among health care workers (HCWs) in China (hereafter surviving HCWs). Methods A total of 303 surviving HCWs were included. Lung (pulmonary function test, 6-min walk test [6MWT], chest CT), physical (St. George’s Respiratory Questionnaire [SGRQ], Modified Medical Research Council dyspnea scale [mMRC], and Borg scale), and psychiatric functions (Essen Trauma Inventory) were evaluated during the 1-year follow-up. Results Surviving HCWs had an abnormal diffusion capacity 1 year post-discharge. Participants with a reduced carbon monoxide diffusing capacity (DLCO) comprised 43.48%. The proportion of HCWs with a median 6MWT distance below the lower limit of the normal was 19.4%. An abnormal CT pattern was observed in 37.5% of the HCWs. The SGRQ, mMRC, and Borg scores of surviving HCWs, especially those with critical/severe disease, were significantly higher than those in the normal population. Probable post-traumatic stress disorder (PTSD) was reported in 21.9% of the surviving HCWs. Diffusion capacity impairment was associated with women. Critical/severe illness and nurses were associated with impaired physical function. Conclusions Most surviving HCWs, especially female HCWs, still had an abnormal diffusion capacity at 1 year. The physical and psychiatric functions of surviving HCWs were significantly worse than those of the healthy population. Long-term follow-up of pulmonary, physical, and psychiatric functions for surviving HCWs is required. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00553-0.

Risk factors for impaired pulmonary diffusion function in convalescent COVID-19 patients: A systematic review and meta-analysis

“…In most studies, the diagnostic criterion for the impairment of DLCO was DLCO < 80% of predicted. 17 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 Except for the study performed by Ayad Mohammed Salem, 41 the diagnostic criterion was DLCO < 75% of predicted. There were 100% follow-up rates in 14 studies, 17 , 26 , 27 , 28 , 29 , 30 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 90% in two studies 31 , 32 , 51% in one study 25 and 87.3% in one study 39 Seventeen studies 17 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 have reported 14.3% to 67% COVID-19 survivors with impaired diffusing capacity for carbon monoxide.…”

“…All of the 18 included studies are observational studies, of which 16 are cohort studies, 17 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 one is a prospective, cross-sectional study 40 and one is a cross-sectional case-control study. 41 The included studies were published between 2020 and 2021 and were conducted in seven countries including China, Germany, Italy, Spain, Chile, Norway and Saudi Arabia.…”

“…17 papers 17 , 25 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 reported risk factors associated with DLCO impairment and 12 studies were included in the meta-analysis. 17 , 25 , 26 , 28 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 One mentioned risk factor for diffusion capacity for nitric oxide (DLNO) impairment. 27 Due to insufficient data and uncertain definitions of DLNO and Restrictive Pattern, this review focuses on a meta-analysis of risk factors for impaired DLCO.…”

“…All selected studies were assessed for methodological quality with NOS. The NOS score of 12 studies included in the meta-analysis was 7.6 (IQR: 7.0–9.0), indicating that all included studies were of high (50%) 17 , 25 , 26 , 28 , 34 , 41 or moderate (50%) 35 , 36 , 37 , 38 , 39 , 40 quality literature. The quality of evidence (GRADE) in the analyzed studies was “low” or “very low”.…”

“…A total of seven studies 25 , 26 , 35 , 36 , 37 , 39 , 41 have shown that being female is associated with a higher risk for impaired DLCO. Female recovered patients showed a 4-fold greater risk of impaired DLCO than male recovered patients (OR: 4.011; 95% CI: 2.928–5.495).…”