Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge

Bellan, Mattia; Soddu, Daniele; Balbo, Piero Emilio; Baricich, Alessio; Zeppegno, Patrizia; Avanzi, Gian Carlo; Baldon, Giulia; Bartolomei, Giuseppe; Battaglia, Marco; Battistini, Sofia; Binda, V.; Borg, Margherita Beatrice; Cantaluppi, Vincenzo; Castello, Luigi Mario; Clivati, Elisa; Cisari, Carlo; Costanzo, Martina; Croce, Alessandro; Cuneo, Daria; Benedittis, Carla De; Vecchi, Simona De; Feggi, A.; Gai, Martina; Gambaro, E.; Gattoni, E.; Gramaglia, Carla; Grisafi, Leonardo; Guerriero, C.; Hayden, Eyal; Jona, Amalia; Invernizzi, Marco; Lorenzini, Luca; Loreti, Lucia; Martelli, María; Marzullo, Paolo; Matino, Erica; Panero, Antonio; Parachini, Elena; Patrucco, Filippo; Patti, Giuseppe; Pirovano, Alice; Prosperini, P.; Quaglino, Riccardo; Rigamonti, Cristina; Sainaghi, Pier Paolo; Vecchi, Camilla; Zecca, Erika; Pirisi, Mario

doi:10.1001/jamanetworkopen.2020.36142

Cited by 419 publications

(489 citation statements)

References 41 publications

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“…[21–30] Yet, only few studies have assessed the persistence of symptoms beyond three months of follow-up. [5,6,9]…”

Section: Discussionmentioning

confidence: 99%

“…Another cohort of 238 patients who suffered from severe COVID-19 requiring hospitalisation also found a higher prevalence (50%) of persistent symptoms four months after hospital discharge compared to our study. [6] Logue et al presented data from a longitudinal cohort of 177 infected individuals, which included 91% of participants with asymptomatic or mild disease. [9] They reported that 33% of outpatients and 31% of hospitalized patients reported persistent symptoms, with fatigue (14%) and loss of taste or smell (14%) being the most common.…”

Section: Discussionmentioning

confidence: 99%

“…However, despite the current challenges in making comparisons, a high prevalence of fatigue, dyspnoea or exercise intolerance, and psychological symptoms are consistently noted across studies. [5,6,9–11]…”

Section: Discussionmentioning

confidence: 99%

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Burden of Post-COVID-19 Syndrome and Implications for Healthcare Service Planning: A Population-based Cohort Study

Menges

Ballouz

Anagnostopoulos

et al. 2021

Preprint

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ObjectiveTo assess the prevalence of impaired health status and physical and mental health symptoms among individuals at least six months after SARS-CoV-2 infection, and to characterise their healthcare utilisation.DesignPopulation-based prospective cohort study.SettingZurich SARS-CoV-2 Cohort, Zurich, Switzerland.Participants431 adults from the general population with PCR-confirmed SARS-CoV-2 infection reported to health authorities between 27 February 2020 and 05 August 2020.Main outcome measuresWe assessed the proportion of individuals reporting not having fully recovered since SARS-CoV-2 infection, the proportion reporting fatigue (assessed by Fatigue Assessment Scale), dyspnoea (assessed by mMRC dyspnoea scale) or depression (assessed by DASS-21) at six to eight months after diagnosis. We further evaluated the proportion of individuals with at least one healthcare contact since their acute illness. Multivariable logistic regression models were used to assess factors associated with the main outcomes.ResultsSymptoms were present in 385 (89%) participants at diagnosis and 81 (19%) were initially hospitalised. At six to eight months, 111 (26%) reported not having fully recovered. 233 (55%) participants reported symptoms of fatigue, 96 (25%) had at least grade 1 dyspnoea, and 111 (26%) had DASS-21 scores indicating symptoms of depression. 170 (40%) participants reported at least one general practitioner visit related to COVID-19 after acute illness, and 10% (8/81) of initially hospitalised individuals were rehospitalised. Individuals that have not fully recovered or suffer from fatigue, dyspnoea or depression were more likely to have further healthcare contacts. However, a third of individuals (37/111) that have not fully recovered did not seek further care.ConclusionIn our population-based study, a relevant proportion of individuals suffered from longer-term consequences after SARS-CoV-2 infection. Our findings indicate that a considerable number of individuals affected by post-COVID-19 syndrome is to be expected, and that a wide range of additional healthcare services and integrative approaches will be required to support the recovery of these individuals. Thus, the timely planning of resources and services for post-COVID-19 care will be necessary alongside public health measures to mitigate the effects of the pandemic.RegistrationISRCTN14990068

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“…[21–30] Yet, only few studies have assessed the persistence of symptoms beyond three months of follow-up. [5,6,9]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Burden of Post-COVID-19 Syndrome and Implications for Healthcare Service Planning: A Population-based Cohort Study

Menges

Ballouz

Anagnostopoulos

et al. 2021

Preprint

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“…A small cohort of critically ill COVID-19 patients also showed alteration in the diffusing capacity of the lung for carbon monoxide (D LCO ) for up to 3 months (20,27,38,40). Persistent D LCO impairment was also detected in non-critical COVID-19 patients that also presented shortness of breath and dyspnea up to 4 months after infection (18,22,33,43). Unlike the above cited studies which analyzed exclusively critically ill patients and two case-reports that analyzed solely mild COVID-19 patients (30,42) all other studies analyzed heterogeneous cohorts of patients, i.e., from mild to severe.…”

Section: Persistent Lung Symptoms and Dysfunctionsmentioning

confidence: 99%

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

et al. 2021

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Whilst the entire world is battling the second wave of COVID-19, a substantial proportion of patients who have suffered from the condition in the past months are reporting symptoms that last for months after recovery, i. e., long-term COVID-19 symptoms. We aimed to assess the current evidence on the long-term symptoms in COVID-19 patients. We did a systematic review on PubMed, Web of Science, EMBASE, and Google Scholar from database inception to February 15, 2021, for studies on long-term COVID-19 symptoms. We included all type of papers that reported at least one long-term COVID-19 symptom. We screened studies using a standardized data collection form and pooled data from published studies. Cohort cross-sectional, case-report, cases-series, case-control studies, and review were graded using specific quality assessment tools. Of 11,361 publications found following our initial search we assessed 218 full-text articles, of which 145 met all selection criteria. We found that 20.70% of reports on long-term COVID-19 symptoms were on abnormal lung functions, 24.13% on neurologic complaints and olfactory dysfunctions, and 55.17% on specific widespread symptoms, mainly chronic fatigue, and pain. Despite the relatively high heterogeneity of the reviewed studies, our findings highlighted that a noteworthy proportion of patients who have suffered from SARS-CoV-2 infection present a “post-COVID syndrome.” The multifaceted understanding of all aspects of the COVID-19 pandemic, including these long-term symptoms, will allow us to respond to all the global health challenges, thus paving the way to a stronger public health.

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“…It should be noted that the quality of the studies from which the information is extracted is low, and so is the power of the conclusions (mostly cohort studies, in some of which, the main objective was not the nature of symptoms, and in which the method of recruitment was variable, including self-selection surveys (high risk of bias)). There are few prospective studies with assessments beyond 12 weeks [31,[35][36][37][38][39] fulfilling the NHS current criteria for post-COVID-19 syndrome. [40][41][42][43][44][45][46][47][48][49][50] or outpatients [51][52][53][54][55][56], evaluated between 4 and 12 weeks after diagnosis.…”

Section: Clinical Manifestations Of Post-covid-19 Syndromementioning

confidence: 99%

Post-COVID-19 Syndrome and the Potential Benefits of Exercise

Jimeno-Almazán

Pallarés

Buendía-Romero

et al. 2021

IJERPH

263

163

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The coronavirus disease (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection, is leading to unknown and unusual health conditions that are challenging to manage. Post-COVID-19 syndrome is one of those challenges, having become increasingly common as the pandemic evolves. The latest estimates suggest that 10 to 20% of the SARS-CoV-2 patients who undergo an acute symptomatic phase are experiencing effects of the disease beyond 12 weeks after diagnosis. Although research is beginning to examine this new condition, there are still serious concerns about the diagnostic identification, which limits the best therapeutic approach. Exercise programs and physical activity levels are well-known modulators of the clinical manifestations and prognosis in many chronic diseases. This narrative review summarizes the up-to-date evidence on post-COVID-19 syndrome to contribute to a better knowledge of the disease and explains how regular exercise may improve many of these symptoms and could reduce the long-term effects of COVID-19.

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Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge

Cited by 419 publications

References 41 publications

Burden of Post-COVID-19 Syndrome and Implications for Healthcare Service Planning: A Population-based Cohort Study

Burden of Post-COVID-19 Syndrome and Implications for Healthcare Service Planning: A Population-based Cohort Study

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

Post-COVID-19 Syndrome and the Potential Benefits of Exercise

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