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Published on: September 30, 2020
Post-sequelae one year after hospital discharge among older COVID-19 patients: A multi-center prospective cohort
Xiaoyu Fang1, Chao Ming2, Yuan Cen3
1Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China; College of Public Health, Southwest Medical University, Luzhou, Sichuan, China.
Background:
To systematically evaluate the prevalence of post-sequelae and chronic obstructive pulmonary disease assessment test (CAT) scoring one year after hospital discharge among older COVID-19 patients, as well as potential risk factors.
Methods:
A multi-center prospective cohort study involving 1,233 eligible older COVID-19 patients was conducted. All patients were followed-up between Mar 1, 2021 and Mar 20, 2021. CAT scoring was adopted to measure symptom burden in COVID-19 patients.
Results:
Of the 1233 eligible cases, 630 (51.1%) reported at least one sequelae. The top six post-sequelae included fatigue (32.4%), sweating (20.0%), chest tightness (15.8%), anxiety (11.4%), myalgia (9.0%), and cough (5.8%). Severe patients had significantly higher percentage of fatigue, sweating, chest tightness, myalgia, and cough (P<0.05), while anxiety was universal in all subjects. Sweating, anxiety, palpitation, edema of lower limbs, smell reduction, and taste change were emerging sequelae. Disease severity during hospitalization (OR: 1.46, 95% CI: 1.15-1.84, P = 0.002), and follow-up time (OR: 0.71, 95% CI: 0.50-0.99, P = 0.043) were independently associated with risk of post-sequelae, while disease severity during hospitalization was significantly associated with increased risk of emerging sequelae (OR: 1.33, 95% CI: 1.03-1.71, P = 0.029). The median of CAT score was 2 (0-5) in all patients, and a total of 120 patients (9.7%) had CAT scores ≥10. Disease severity during hospitalization (OR: 1.81, 95% CI: 1.23-2.67, P = 0.003) and age (OR: 1.07, 95% CI: 1.04-1.09, P<0.001) were significantly associated with increased risk of CAT scores ≥10.
Conclusions:
While the dramatic decline in the prevalence rate of persistent symptoms is reassuring, new sequelae among older COVID-19 patients cannot be ignored. Disease severity during hospitalization, age, and follow-up time contributed to the risk of post-sequelae and CAT scoring one year after hospital discharge among older COVID-19 patients. Our study provides valuable clues for long-term post-sequelae of the older COVID-19 patients, as well as their risk factors.
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