Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up

Abstract

Post-COVID-19 syndrome (PCS) has been described as ‘the pandemic after the pandemic’ with more than 65 million people worldwide being affected. The enormous range of symptoms makes both diagnosis complex and treatment difficult. In a post-COVID rehabilitation outpatient clinic, 184 patients, mostly non-hospitalized, received a comprehensive, interdisciplinary diagnostic assessment with fixed follow-up appointments. At baseline, three in four patients reported more than 10 symptoms, the most frequent symptoms were fatigue (84.9%), decreased physical capacity (83.0%), tiredness (81.1%), poor concentration (73.6%), sleeping problems (66.7%) and shortness of breath (67.3%). Abnormalities were found in the mean values of scores for fatigue (FAS = 34.3), cognition (MoCA = 25.5), psychological alterations (anxiety, depression, post-traumatic stress disorder), limitation of lung function (CAT) and severity scores for PCS (PCFS, MCRS). Clinical abnormalities were found in elevated values of heart rate, breathing rate at rest, blood pressure and NT-proBNP levels. As the frequency of the described symptoms decreases only slowly but most often significantly over the course, it is important to monitor the patients over a longer period of time. Many of them suffer from an immense symptom burden, often without pre-existing clinical correlates. Our results show a clear association with objectifiable assessments and tests as well as pronounced symptoms.

Is Recovery Just the Beginning? Persistent Symptoms and Health and Performance Deterioration in Post-COVID-19, non-hospitalised University Students - A Cross-Sectional Study

“…This upward trend was statistically significant in the case of fatigue experienced after work (for all, and women) and after a long train journey (for women). Our results diverged from those studies that reported decreasing levels of fatigue over time in COVID-19 patients (Fumagalli et al, 2022; Steinmetz et al, 2023; Van Herck et al, 2021). However, they align with the findings of a study that observed a trend of increasing fatigue over the months 1, 3, 6, and 12 following the onset of COVID-19 infection (Mazza et al, 2022).…”

Longitudinal Changes in Physical Function and Their Impact on Health Outcomes in COVID-19 Patients

“…Our findings are consistent with a large Canadian study that identified fatigue as a significant predictor of declining health-related quality of life after COVID-19 [40]. Although physical function and quality of life improve over time in COVID-19 survivors, an impairment in these health-related outcomes persists in a significant proportion of patients [40,41]. These data suggest that HGS should be assessed soon after discharge to identify patients who may need additional care to improve their health status.…”

Improvement in quality of life and cognitive function in Post Covid Syndrome after online occupational therapy: results from a randomized controlled pilot study

“…Their cognitive function showed statistically significantly improvement and their health-related quality of life had increased by 0.11 points, a value clearly above the threshold of 0.03 previously described to be clinically relevant [23]. The fact that secondary outcomes such as memory and concentration capacity also improved in the control group could be explained by a natural amelioration of PCS symptoms over time, which has also been observed by other researchers [24]. Importantly, only patients receiving interactive OT showed significant improvement of all measured endpoints of cognitive function, occupational problems, quality of life, and social participation.…”