Symptoms and Health Outcomes Among Survivors of COVID-19 Infection 1 Year After Discharge From Hospitals in Wuhan, China

Zhang, Xue; Wang, Fang; Shen, Ye; Zhang, Xiaohua; Yuan, Cheng; Wang, Bin; Zhao, Songtao; Zhou, Yi; Hu, Baoman; Wang, Man; Liu, Yuhui; Miao, Hongming; Jones, Paul; Ma, Xiangyu; He, Yong; Cao, Guoqiang; Cheng, Lü; Li, Li

doi:10.1001/jamanetworkopen.2021.27403

Cited by 191 publications

(228 citation statements)

References 34 publications

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“… 35 Similar results were obtained by a longitudinal analysis of 2433 patients with antecedent SARS-CoV-2 infection; at 1-year follow-up, the reported neurological symptoms included fatigue (30%), myalgia (8%), dizziness (3%), headache (2%), and taste/smell disorders (1%). 5 In an online international survey of 3762 participants with antecedent COVID-19, however, a much higher prevalence of neurological manifestations affecting the CNS and PNS was reported. 32 In the first 6 months after acute disease, the most frequently reported symptoms encompassed sensorimotor deficits (91%), cognitive dysfunction (85%), emotional/mood disorders (88%), sleep disturbances (79%), headache (77%), memory impairment (73%), and smell/taste disorders (58%).…”

Section: Neurological Manifestations Of ‘Long-covid’ Syndromementioning

confidence: 99%

“… 106 , 109 Discordant findings are also found in the literature concerning the contribution of demographic factors to ‘long-COVID’. With respect to age, for example, although a number of studies support that increasing age confers an increased susceptibility to long-term sequelae, 5 , 40 , 109 other studies reported that younger patients may be at higher risk of ‘long-COVID’. 110 Moreover, a striking prevalence of ‘long-COVID’ symptoms of nearly 43% has been reported in children with antecedent SARS-CoV-2 infection, albeit these prevalence estimates remain debatable.…”

Section: Diagnostic Approach To Neurological ‘Long-covid’ Sequelaementioning

confidence: 99%

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Neurological manifestations of long-COVID syndrome: a narrative review

Stefanou

Palaiodimou

Bakola

et al. 2022

Therapeutic Advances in Chronic Disease

177

128

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Accumulating evidence points toward a very high prevalence of prolonged neurological symptoms among coronavirus disease 2019 (COVID-19) survivors. To date, there are no solidified criteria for ‘long-COVID’ diagnosis. Nevertheless, ‘long-COVID’ is conceptualized as a multi-organ disorder with a wide spectrum of clinical manifestations that may be indicative of underlying pulmonary, cardiovascular, endocrine, hematologic, renal, gastrointestinal, dermatologic, immunological, psychiatric, or neurological disease. Involvement of the central or peripheral nervous system is noted in more than one-third of patients with antecedent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while an approximately threefold higher incidence of neurological symptoms is recorded in observational studies including patient-reported data. The most frequent neurological manifestations of ‘long-COVID’ encompass fatigue; ‘brain fog’; headache; cognitive impairment; sleep, mood, smell, or taste disorders; myalgias; sensorimotor deficits; and dysautonomia. Although very limited evidence exists to date on the pathophysiological mechanisms implicated in the manifestation of ‘long-COVID’, neuroinflammatory and oxidative stress processes are thought to prevail in propagating neurological ‘long-COVID’ sequelae. In this narrative review, we sought to present a comprehensive overview of our current understanding of clinical features, risk factors, and pathophysiological processes of neurological ‘long-COVID’ sequelae. Moreover, we propose diagnostic and therapeutic algorithms that may aid in the prompt recognition and management of underlying causes of neurological symptoms that persist beyond the resolution of acute COVID-19. Furthermore, as causal treatments for ‘long-COVID’ are currently unavailable, we propose therapeutic approaches for symptom-oriented management of neurological ‘long-COVID’ symptoms. In addition, we emphasize that collaborative research initiatives are urgently needed to expedite the development of preventive and therapeutic strategies for neurological ‘long-COVID’ sequelae.

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Section: Neurological Manifestations Of ‘Long-covid’ Syndromementioning

confidence: 99%

Section: Diagnostic Approach To Neurological ‘Long-covid’ Sequelaementioning

confidence: 99%

Neurological manifestations of long-COVID syndrome: a narrative review

Stefanou

Palaiodimou

Bakola

et al. 2022

Therapeutic Advances in Chronic Disease

177

128

View full text Add to dashboard Cite

show abstract

“…It should be noted that most studies included samples with <500 participants, were conducted in one single center, included follow-up periods shorter than 12 weeks and did not specifically focus on sex differences [15][16][17][18][19][20][21][22][23][24][25]. Three recent multicenter studies have been published [26][27][28]. Sigfrid et al included 327 hospitalized COVID-19 survivors from five hospitals and reported that females younger than 50 years were two times more likely to report fatigue and seven times more likely to report dyspnea than men of the same age seven months after hospital discharge [26].…”

Section: Introductionmentioning

confidence: 99%

Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study

Fernández‐de‐las‐Peñas

Martín-Guerrero

Pellicer-Valero

et al. 2022

JCM

217

121

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This multicenter cohort study investigated the differences between coronavirus disease 2019 (COVID-19) related symptoms and post-COVID symptoms between male and female COVID-19 survivors. Clinical and hospitalization data were collected from hospital medical records in a sample of individuals recovered from COVID-19 at five public hospitals in Spain. A predefined list of post-COVID symptoms was systematically assessed, but patients were free to report any symptom. Anxiety/depressive levels and sleep quality were also assessed. Adjusted multivariate logistic regressions were used to identify the association of sex with post-COVID related-symptoms. A total of 1969 individuals (age: 61, SD: 16 years, 46.4% women) were assessed 8.4 months after discharge. No overall significant sex differences in COVID-19 onset symptoms at hospital admission were found. Post-COVID symptoms were present in up to 60% of hospitalized COVID-19 survivors eight months after the infection. The number of post-COVID symptoms was 2.25 for females and 1.5 for males. After adjusting by all variables, female sex was associated with ≥3 post-COVID symptoms (adj OR 2.54, 95%CI 1.671–3.865, p < 0.001), the presence of post-COVID fatigue (adj OR 1.514, 95%CI 1.040–2.205), dyspnea (rest: adj OR 1.428, 95%CI 1.081–1.886, exertion: adj OR 1.409, 95%CI 1.109–1.791), pain (adj OR 1.349, 95%CI 1.059–1.720), hair loss (adj OR 4.529, 95%CI 2.784–7.368), ocular problems (adj OR 1.981, 95%CI 1.185–3.312), depressive levels (adj OR 1.606, 95%CI 1.002–2.572) and worse sleep quality (adj OR 1.634, 95%CI 1.097–2.434). Female sex was a risk factor for the development of some long-term post-COVID symptoms including mood disorders. Healthcare systems should consider sex differences in the management of long haulers.

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“…This process leads some alveolocapillary units to higher V / Q ratios. While COVID-19 survivors are considered disease-free regarding the acute phase [ 22 ], persistent oxygen desaturation and fatigue are commonly reported in the post-acute period.…”

Section: Discussionmentioning

confidence: 99%

Physical Fitness Differences, Amenable to Hypoxia-Driven and Sarcopenia Pathophysiology, between Sleep Apnea and COVID-19

Stavrou

Vavougios

Boutlas

et al. 2022

IJERPH

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Handgrip strength is an indirect indicator of physical fitness that is used in medical rehabilitation for its potential prognostic value. An increasing number of studies indicate that COVID-19 survivors experience impaired physical fitness for months following hospitalization. The aim of our study was to assess physical fitness indicator differences with another prevalent and hypoxia-driven disease, Obstructive Sleep Apnea Syndrome (OSAS). Our findings showed differences between post-COVID-19 and OSAS groups in cardiovascular responses, with post-COVID-19 patients exhibiting higher values for heart rate and in mean arterial blood pressure. Oxygen saturation (SpO2) was lower in post-COVID-19 patients during a six-minute walking test (6MWT), whereas the ΔSpO2 (the difference between the baseline to end of the 6MWT) was higher compared to OSAS patients. In patients of both groups, statistically significant correlations were detected between handgrip strength and distance during the 6MWT, anthropometric characteristics, and body composition parameters. In our study, COVID-19 survivors demonstrated a long-term reduction in muscle strength compared to OSAS patients. Lower handgrip strength has been independently associated with a prior COVID-19 hospitalization. The differences in muscle strength and oxygenation could be attributed to the abrupt onset of the disorder, which does not allow compensatory mechanisms to act effectively. Targeted rehabilitation focusing on such residual impairments may thus be indispensable within the setting of post-COVID-19 syndrome.

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Symptoms and Health Outcomes Among Survivors of COVID-19 Infection 1 Year After Discharge From Hospitals in Wuhan, China

Abstract: IMPORTANCEThe long-term health outcomes and symptom burden of COVID-19 remain largely unclear.

Cited by 191 publications

References 34 publications

Neurological manifestations of long-COVID syndrome: a narrative review

Neurological manifestations of long-COVID syndrome: a narrative review

Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study

Physical Fitness Differences, Amenable to Hypoxia-Driven and Sarcopenia Pathophysiology, between Sleep Apnea and COVID-19

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