Symptom Burden among Older COVID-19 Survivors Two Years after Hospital Discharge

Abstract

To study the long-term symptom burden among older COVID-19 survivors 2 years after hospital discharge and identify associated risk factors. The current cohort study included COVID-19 survivors aged 60 years and above, who were discharged between February 12 and April 10, 2020, from two designated hospitals in Wuhan, China. All patients were contacted via telephone and completed a standardized questionnaire assessing self-reported symptoms, the Checklist Individual Strength (CIS)-fatigue subscale, and two subscales of the Hospital Anxiety and Depression Scale (HADS). Of the 1,212 patients surveyed, the median (IQR) age was 68.0 (64.0-72.0), and 586 (48.3%) were male. At the two-year follow-up, 259 patients (21.4%) still reported at least one symptom. The most frequently self-reported symptoms were fatigue, anxiety, and dyspnea. Fatigue or myalgia, which was the most common symptom cluster (11.8%; 143/1212), often co-occurred with anxiety and chest symptoms. A total of 89 patients (7.7%) had CIS-fatigue scores ≥ 27, with older age (odds ratio [OR], 1.08; 95% CI: 1.05-1.11, P < 0.001) and oxygen therapy (OR, 2.19; 95% CI: 1.06-4.50, P= 0.03) being risk factors. A total of 43 patients (3.8%) had HADS-Anxiety scores ≥ 8, and 130 patients (11.5%) had HADS-Depression scores ≥ 8. For the 59 patients (5.2%) who had HADS total scores ≥ 16, older age, serious illness during hospitalization and coexisting cerebrovascular diseases were risk factors. Cooccurring fatigue, anxiety, and chest symptoms, as well as depression, were mainly responsible for long-term symptom burden among older COVID-19 survivors 2 years after discharge.

Prevalence of depressive symptoms and correlates among individuals who self-reported SARS-CoV-2 infection after optimizing the COVID-19 response in China

“…A possible explanation may be the fear of the high mortality of COVID-19 ( 63 ), which might significantly contribute to an increased risk of developing depressive symptoms. Furthermore, research indicated that individuals who have been hospitalized with COVID-19 are at a high risk of experiencing post-COVID-19 syndrome ( 64 – 67 ), potentially reflecting poor prognosis which may cause worry and stress among inpatients. Therefore, timely communication with patients about their health status and progress of treatment is necessary to alleviate their fear of uncertainty.…”

Incidence of fatigue 2 years after SARS‐CoV‐2 infection: An updated meta‐analysis and subgroup analysis

“…1 We attempted to identify new eligible studies that reported the incidence of post-COVID fatigue 2 years after COVID-19 infection. Finally, nine new studies were identified, four from Asian countries [2][3][4][5] and five from non-Asian countries. [6][7][8][9][10] We pooled these data from the new studies with 10 studies in the original meta-analysis 1 using Comprehensive Meta-Analysis software (Version 4, Biostat).…”