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Published on: December 19, 2020
Prognostic Factors for Predicting Post-COVID-19 Condition in Patients With COVID-19 in an Outpatient Setting
Myeong Geun Choi1, Young Woong Joo2, Min-Ho Kim3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
Insights
Not using antiviral drugs and low vitamin D levels are key factors prolonging COVID-19 symptoms in outpatients. Early antiviral treatment and vitamin D supplementation may shorten symptom duration and reduce post-COVID-19 conditions.
Area of Science:
- Infectious Diseases
- Pulmonology
- Public Health
Background:
- Limited understanding of prognostic factors for symptom duration in non-hospitalized COVID-19 patients.
- Need to identify predictors for prolonged post-COVID-19 conditions.
Purpose of the Study:
- Investigate prognostic factors influencing symptom duration in COVID-19 outpatients.
- Identify predictors for developing post-COVID-19 conditions.
Main Methods:
- Analysis of data from 257 mild COVID-19 outpatients (April-December 2022).
- Symptom duration measured from diagnosis to resolution.
- Collected laboratory and pulmonary function test data.
Main Results:
- Median symptom duration was 57 days.
- Prolonged symptoms correlated with no antiviral use, leukocytosis, low 25(OH)D3, reduced FVC (<90%), dyspnea, and anxiety/depression.
- Not using antivirals, low vitamin D, and dyspnea were independent poor prognostic factors.
Conclusions:
- Non-use of antivirals, low vitamin D, leukocytosis, reduced FVC, dyspnea, and anxiety/depression predict post-COVID-19 conditions.
- Antiviral use during acute phase and vitamin D may reduce symptom duration.
Background:
Although data on post-coronavirus disease 2019 (COVID-19) conditions are extensive, the prognostic factors affecting symptom duration in non-hospitalized patients with COVID-19 are currently not well known. We aimed to investigate the various prognostic factors affecting symptom duration among outpatients with COVID-19.
Methods:
Data were analyzed from 257 patients who were diagnosed with mild COVID-19 and visited the 'post-COVID-19 outpatient clinic' between April and December 2022 after a mandatory isolation period. The symptom duration was measured from diagnosis to symptom resolution. Laboratory and pulmonary function test results from their first visit were collected.
Results:
The mean age of patients was 55.7 years, and the median symptom duration was 57 days. The development of post-COVID-19 conditions (> 12 weeks) were significantly correlated with not using antiviral drugs, leukocytosis (white blood cell > 10,000/µL), lower 25(OH)D3 levels, forced vital capacity (FVC) < 90% predicted, and presence of dyspnea and anxiety/depression. Additionally, in multivariable Cox regression analysis, not using antiviral drugs, lower 25(OH)D3 levels, and having dyspnea were poor prognostic factors for longer symptom duration. Particularly, vitamin D deficiency (< 20 ng/mL) and not using antivirals during the acute phase were independent poor prognostic factors for both post-COVID-19 condition and longer symptom duration.
Conclusion:
The non-use of antivirals, lower 25(OH)D3 levels, leukocytosis, FVC < 90% predicted, and the presence of dyspnea and anxiety/depression symptoms could be useful prognostic factors for predicting post-COVID-19 condition in outpatients with COVID-19. We suggest that the use of antiviral agents during the acute phase and vitamin D supplements might help reduce COVID-19 symptom duration.
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