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Long-term outcomes of patients following hospitalization for coronavirus disease 2019: a prospective observational study

2021; Elsevier BV; Volume: 27; Issue: 8 Linguagem: Inglês

10.1016/j.cmi.2021.04.002

1469-0691

Yolanda Meije, Alejandra Duarte-Borges, X. Sanz, Mercedes Clemente, Alba Ribera, Lucía Ortega, Ruth González-Pérez, Roser Cid, Júlia Pareja, Irene Cantero, M. de Ariño, Teresa Sagués, Jaume Llaberia, Ana Ayestarán, Núria Fernández-Hidalgo, Beatriz Candás‐Estébanez, N. Alguersuari, A. Arderiu, Natalia Baeza, Jordi Bugés, Javier Trujillano, Manuela Riera Campillo, Jose García Cantos, Ester Castellarnau, A. Coco, I. Coll, David Coroleu, João Marcelo de Souza Costa, Xavier Demestre, P. Díez-Cascón, M.J. Elizari, I. Escape, N. Espaulella, Jordi Fabregat, C. Ferré, Marta Ferrer‐García, Fernando Silveira Franco, Jayasri Helen Gali, Eva García, J. Garrillo, C Guzman, Luis Iglesias, Leonor Invernon, José Jimeno, Joana Baptista de Lima, M León, Gerard Martí, Sergio Calero Martinez, J. Martínez-Agea, L. Martínez-Fijo, Joaquin Martínez‐Montauti, Alejandra Martínez‐Trillos, S. Mechó, A. Coutado Méndez, Bianca Ramírez Mendiola, Jordi Mercé, Fernanda Moura D’Almeida Miranda, J. Morillas, M Montané, A. Musolas, Ariel Odriozola, V. Pagès, Javier Palau, Marinésia Aparecida Prado Palos, Eliana L. Parra-Barrera, Joan Ramon Pérez-Mas, K. Pizurno, Meritxell Ponce, Sandrine Pons, D. Redó, Natàlia Rodón, G. Rodríguez-Froxán, Analía Santamaría, Carolina Sitges, Nadia Stasi, Júlia Maria Pavan Soler, Ainhoa Torrens, M. Vaqué, Laura Ventura, C. Vericat, Anne J. Vila,

COVID-19 and healthcare impacts

ObjectivesFew data are available regarding follow up of patients with coronavirus disease 2019 (COVID-19) after their discharge. We aim to describe the long-term outcomes of survivors of hospitalization for COVID-19 followed up first at an outpatient facility and subsequently by telephone.MethodsObservational prospective study conducted at a tertiary general hospital. Clinical and radiological progression was assessed and data were recorded on a standardized reporting form. Patients were divided into three groups according to Pao2/Fio2 at hospitalization: Pao2/Fio2 >300, Pao2/Fio2 300–200 and Pao2/Fio2 <200. A logistic multivariate regression model was performed to identify factors associated with persistence of symptoms.ResultsFor facility follow up, 302 individuals were enrolled. Median follow up was 45 days after discharge; 78% (228/294) of patients had COVID-19-related symptoms (53% asthenia, 56% respiratory symptoms) and 40% (122/302) had residual pulmonary radiographic lesions. Pao2/Fio2 <200 was an independent predictor of persistent dyspnoea (OR 1.87, 95% CI 1.38–2.52, p < 0.0001). Pao2/Fio2 >300 was associated with resolution of chest radiographic lesions (OR 0.56, 95% CI 0.42–0.74, p < 0.0001). Fifty per cent of patients required specific medical follow up after the first consultation and were transferred to another physician. A total of 294 patients were contacted for telephone follow up after a median follow-up time of 7 months. Fifty per cent of patients (147/294) still presented symptoms and 49% (145/294) had psychological disorders. Asthenia was identified in 27% (78/294) and dyspnoea in 10% (28/294) of patients independently of Pao2/Fio2.ConclusionsPatients with COVID-19 require long-term follow up because of the persistence of symptoms; patients with low Pao2/Fio2 during the acute illness require special attention.Graphical abstract