Journal
JOURNAL OF INFECTION AND PUBLIC HEALTH
Volume 15, Issue 1, Pages 21-28Publisher
ELSEVIER SCIENCE LONDON
DOI: 10.1016/j.jiph.2021.11.016
Keywords
Post-acute COVID-19 syndrome; PACS; Long COVID; Breathlessness; Exercise intolerance; Chronic fatigue; Well-being
Funding
- COVID-19 research grant [CoV19-0307]
- Sandooq Al Watan Applied Research & Development grant [SWARD-S20-007]
- Al Jalila Foundation Seed Grant [AJF202019]
- Prince Abdullah Ben Khalid Celiac Disease Research Chair, under the Vice Deanship of Research Chairs, King Saud University, Riyadh, Kingdom of Saudi Arabia
- [tel:2001090275]
- [tel:2001090278]
- [2001090283]
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A study was conducted to determine predictors of different functional outcomes after hospital discharge in COVID-19 patients, showing several risk factors associated with an increased risk of PACS. Factors such as female gender, older age, pre-existing lung disease, and emergency room visits may influence patients' recovery outcomes.
Background: Post-acute COVID-19 syndrome (PACS) is an emerging healthcare burden. We therefore aimed to determine predictors of different functional outcomes after hospital discharge in patients with COVID-19. Methods: An ambidirectional cohort study was conducted between May and July 2020, in which PCR-confirmed COVID-19 patients underwent a standardized telephone assessment between 6 weeks and 6 months post discharge. We excluded patients who died, had a mental illness or failed to respond to two follow-up phone calls. The medical research council (MRC) dyspnea scale, metabolic equivalent of task (MET) score for exercise tolerance, chronic fatigability syndrome (CFS) scale and World Health Organization-five well-being index (WHO-5) for mental health were used to evaluate symptoms at follow-up. Results: 375 patients were contacted and 153 failed to respond. The median timing for the follow-up assessment was 122 days (IQR, 109- 158). On multivariate analyses, female gender, pre-existing lung disease, headache at presentation, intensive care unit (ICU) admission, critical COVID-19 and post-discharge ER visit were predictors of higher MRC scores at follow-up. Female gender, older age >67 years, arterial hypertension and emergency room (ER) visit were associated with lower MET exercise tolerance scores. Female gender, pre-existing lung disease, and ER visit were associated with higher risk of CFS. Age, dyslipidemia, hypertension, pre-existing lung disease and duration of symptoms were negatively associated with WHO-5 score. Conclusions: Several risk factors were associated with an increased risk of PACS. Hospitalized patients with COVID-19 who are at risk for PACS may benefit from a targeted pre-emptive follow-up and rehabilitation programs. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.
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