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Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study
Qiutang Xiong1, Ming Xu1, Jiao Li1
1Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.
Insights
Long COVID symptoms are common in survivors, with fatigue and hair loss more prevalent in women. Hospitalization factors like dyspnea and asthma history influence these long-term effects.
Area of Science:
- Infectious Diseases
- Pulmonology
- General Medicine
Background:
- Coronavirus disease 2019 (COVID-19) survivors may experience persistent clinical issues post-hospitalization.
- Understanding long-term sequelae is crucial for managing patient recovery and healthcare needs.
Purpose of the Study:
- To investigate the prevalence, characteristics, and risk factors of clinical sequelae in COVID-19 survivors discharged for over three months.
- To identify potential associations between patient demographics, hospitalization details, and the development of long-term symptoms.
Main Methods:
- A longitudinal telephone follow-up survey was conducted with COVID-19 patients discharged from Renmin Hospital of Wuhan University.
- Demographic and clinical data were collected, alongside self-reported sequelae.
- A control group of non-COVID-19 individuals from Wuhan was included for comparison.
Main Results:
- Nearly half of the 538 COVID-19 survivors reported general symptoms (49.6%), with significant rates of respiratory symptoms (39%), alopecia (28.6%), and psychosocial symptoms (22.7%).
- Female survivors showed higher rates of physical decline/fatigue, post-activity shortness of breath, and alopecia.
- Dyspnea during hospitalization correlated with subsequent fatigue and increased resting heart rate, while asthma history was linked to shortness of breath.
Conclusions:
- Clinical sequelae are frequent in the early convalescence period following COVID-19.
- Factors such as gender, age, and specific clinical characteristics during hospitalization may influence the occurrence and type of long-term sequelae.
Objectives:
To describe the prevalence, nature and risk factors for the main clinical sequelae in coronavirus disease 2019 (COVID-19) survivors who have been discharged from the hospital for more than 3 months.
Methods:
This longitudinal study was based on a telephone follow-up survey of COVID-19 patients hospitalized and discharged from Renmin Hospital of Wuhan University, Wuhan, China before 1 March 2020. Demographic and clinical characteristics and self-reported clinical sequelae of the survivors were described and analysed. A cohort of volunteers who were free of COVID-19 and lived in the urban area of Wuhan during the outbreak were also selected as the comparison group.
Results:
Among 538 survivors (293, 54.5% female), the median (interquartile range) age was 52.0 (41.0-62.0) years, and the time from discharge from hospital to first follow-up was 97.0 (95.0-102.0) days. Clinical sequelae were common, including general symptoms (n = 267, 49.6%), respiratory symptoms (n = 210, 39%), cardiovascular-related symptoms (n = 70, 13%), psychosocial symptoms (n = 122, 22.7%) and alopecia (n = 154, 28.6%). We found that physical decline/fatigue (p < 0.01), postactivity polypnoea (p= 0.04) and alopecia (p < 0.01) were more common in female than in male subjects. Dyspnoea during hospitalization was associated with subsequent physical decline/fatigue, postactivity polypnoea and resting heart rate increases but not specifically with alopecia. A history of asthma during hospitalization was associated with subsequent postactivity polypnoea sequela. A history of pulse ≥90 bpm during hospitalization was associated with resting heart rate increase in convalescence. The duration of virus shedding after COVID-19 onset and hospital length of stay were longer in survivors with physical decline/fatigue or postactivity polypnoea than in those without.
Conclusions:
Clinical sequelae during early COVID-19 convalescence were common; some of these sequelae might be related to gender, age and clinical characteristics during hospitalization.
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