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6 and 12 month outcomes in patients following COVID-19-related hospitalization: a prospective monocentric study
Giuseppe Pio Martino1, Devis Benfaremo2, Giuseppina Bitti1
1UOC Medicina Interna Fermo, ASUR Marche, Area Vasta 4, Ancona, Italy.
Insights
Long-term symptoms like fatigue and breathing difficulties are common after severe COVID-19 hospitalization. Pulmonary deficits and radiographic abnormalities persist for many patients up to 12 months post-discharge.
Area of Science:
- Pulmonology
- Infectious Diseases
- Post-COVID Conditions
Background:
- The long-term health consequences for individuals hospitalized with severe COVID-19 remain incompletely understood.
- Assessing persistent symptoms and organ function is crucial for managing post-acute sequelae of SARS-CoV-2 infection.
Purpose of the Study:
- To describe the spectrum of long-term symptoms and respiratory outcomes over 12 months in patients hospitalized for severe COVID-19.
- To evaluate the persistence and evolution of pulmonary function deficits and radiographic findings.
Main Methods:
- A prospective cohort study followed 64 patients hospitalized for severe COVID-19.
- Assessments included interviews for symptoms, physical exams, blood tests, pulmonary function tests (PFTs), high-resolution computed tomography (HRCT), and a 6-minute walk test at 6 and 12 months post-discharge.
- Key PFT metrics included diffusing capacity of the lungs for carbon monoxide (DLCO) and forced vital capacity (FVC).
Main Results:
- At 6 months, common persistent symptoms included dyspnea (36%), fatigue (37.5%), hair loss (30.6%), arthralgia (14%), and cognitive deficits (11%).
- Over 50% reported anxiety and depression symptoms. Pulmonary function showed reduced DLCO (57.4%) and FVC (21.3%) at 6 months, with FVC improving by 12 months, but DLCO and total lung capacity (TLC) did not.
- Persistent radiographic abnormalities, such as ground-glass opacities and interstitial changes, were noted in many patients at both follow-up points.
Conclusions:
- Severe COVID-19 hospitalization is associated with a high prevalence of long-term symptoms and significant pulmonary deficits.
- While some respiratory function improves, persistent abnormalities in lung diffusion capacity and imaging findings are common up to one year.
- Further research is warranted to elucidate the clinical implications and management strategies for these long-term post-COVID-19 consequences.
Abstract:
The long-term consequences of COVID-19 in those who recover from acute infection requiring hospitalization have not been defined yet. In this study, we aim to describe the long-term symptoms and respiratory outcomes over 12 months in patients hospitalized for severe COVID-19. In this prospective cohort study, patients admitted to hospital for severe COVID-19 were prospectively followed up at 6 and 12 months after discharge from the Hospital of Fermo, Italy. Patients were interviewed for persisting symptoms and underwent physical examination, routine blood test, pulmonary function tests, chest high-resolution CT (HRCT), and 6 min walking test. A total of 64 patients were evaluated and participated in this study. The mean age of participants was 68 years, 41 (64%) were males, and the median body mass index (BMI) was 26 kg/m2. After 6 months, 36% of patients reported persistent dyspnea, 37.5% persistent fatigue, 30.6% hair loss, 14% arthralgia and 11% memory and attention deficits. The rate of these symptoms reduced at the 12 month follow-up. At least 50% of the patients reported anxiety and depression symptoms. At 6 months 57.4% of patients showed reduced DLCO and 21.3% reduced FVC% and improvement at 12 months was noted for FVC but not for DLCO and TLC. Persistent radiographic abnormalities, most commonly ground-glass opacities and interstitial changes, were observed at both timepoints in many patients. Long-term symptoms and pulmonary deficits are common in patients admitted for severe COVID-19. Further studies are needed to assess the clinical significance of long-term consequences of severe COVID-19.
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