Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection

Abstract

Background Characterizing the prevalence and persistence of symptoms associated with COVID-19 infection following hospitalization and their impact is essential to planning post-acute community-based clinical services. This study seeks to identify persistent COVID-19 symptoms in patients 35 days post-hospitalization and their impact on quality of life, health, physical, mental, and psychosocial function. Methods and findings This prospective cohort study used the PROMIS® Instruments to identify symptoms and quality of life parameters in consecutively enrolled patients between March 22 and April 16, 2020, in New Jersey. The 183 patients (median age 57 years; 61.5% male, 54.1% white) reported persistent symptoms at 35 days, including fatigue (55.0%), dyspnea (45.3%), muscular pain (51%), associated with a lower odds rating general health (41.5%, OR 0.093 [95% CI: 0.026, 0.329], p = 0.0002), quality of life (39.8%; OR 0.116 [95% CI: 0.038, 0.364], p = 0.0002), physical health (38.7%, OR 0.055 [95% CI: 0.016, 0.193], p <0.0001), mental health (43.7%, OR 0.093 [95% CI: 0.021, 0.418], p = 0.0019) and social active role (38.7%, OR 0.095 [95% CI: 0.031, 0.291], p<0.0001), as very good/excellent, particularly adults aged 65 to 75 years (OR 8·666 [95% CI: 2·216, 33·884], p = 0·0019). Conclusions COVID-19 symptoms commonly persist to 35 days, impacting quality of life, health, physical and mental function. Early post-acute evaluation of symptoms and their impact on function is necessary to plan community-based services.

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

“…The main widespread reported long-term symptoms in COVID-19 patients were chronic fatigue, dyspnea, shortness of breath, chest pains, headache, loss of smell/taste, muscle, and joint pain, followed by depression, anxiety, insomnia, and itchy body, heart palpitations, tachycardia, anorexia, tingling fingertips, and brain fog ( 69 , 70 , 72 , 77 , 84 , 85 , 87 , 91 , 97 , 98 , 101 , 103 , 123 , 138 , 145 – 147 , 150 , 156 – 159 ). However, it was reported that the number of widespread long-term symptoms were higher for COVID-19 patients who were initially more ill ( 77 , 100 ).…”

Epidemiology and organ specific sequelae of post-acute COVID19: A narrative review

“…Observational studies deriving from different populations (USA, Europe and Asia) revealed a variable proportion of persistent symptoms following SARS-CoV-2 infection (Table 1, Appendix Table 2). Early studies provided evidence of persistent COVID sequelae reporting short term outcomes covering the post-acute phase (4-12 weeks) of COVID-19 [8,13,17,[19][20][21][22][23]27]. Most recent publications present data from larger cohorts with longer follow-up periods (beyond 12 weeks) illustrating the multisystemic manifestations of the so called "long" or "chronic'' COVID [10,12,18].…”

“…Recently published cohort studies have reported symptoms from most body systems in following the acute disease phase reflecting its multi-systemic nature [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] (Table1, Appendix Table 2).…”

Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients

“…The pathophysiology of post-viral syndromes has been reported to involve a complex interplay between the viral loads and the humoral and cellular immune responses that could elicit both direct non-immunological and indirect immune effects [ 3 , 5 ]. However, the available knowledge of post-COVID-19 syndrome is still poor and controversial due to the lack of a consensus definition [ 6 ], the heterogeneity of the investigated population and diagnostic follow-ups [ 1 , 2 , 7 , 8 ]. A better understanding of the post-COVID-19 syndrome and the dynamics and the nature of immune response to SARS-CoV-2 infection might assist in identifying long-haulers and appropriate pathways of care.…”