Long-term outcomes of patients following hospitalization for coronavirus disease 2019: a prospective observational study

• DOI: 10.1016/j.cmi.2021.04.002
• Publication Date: 2021-04-23T11:32:18Z
• Authors: Yolanda Meije; Alejandra Duarte-...; Xavier Sanz; Mercedes Clemente; Alba Ribera; Lucía Ortega; Ruth González-Pérez; Roser Cid; Júlia Pareja; Irene Cantero; Miquel Ariño; Teresa Sagués; Jaume LLaberia; Ana Ayestarán; Nuria Fernández-H...; Beatriz Candás-Es...; N. Alguersuari; A. Arderiu; N. Baeza; J. Bugés; J. Cabello; M. Campillo; J. Cantos; E. Castellarnau; A. Coco; I. Coll; D. Coroleu; J. Costa; X. Demestre; P. Díez-Cascón; M.J. Elizari; I. Escape; N. Espaulella; J. Fabregat; C. Ferré; M. Ferrer; F. Franco; J. Galí; E. García; J. Garrillo; C. Guzmán; L. Iglesias; L. Invernón; J. Jimeno; J. Lima; M. León; G. Martí; S. Martínez; J. Martínez-Agea; L. Martínez-Fijo; J. Martínez-Montauti; A. Martínez-Trillos; S. Mechó; A. Méndez; B. Mendiola; J. Mercé; F. Miranda; J. Morillas; M. Montané; A. Musolas; A. Odriozola; V. Pagès; J. Palau; M.A. Palos; E. Parra; J.R. Pérez-Mas; K. Pizurno; M. Ponce; S. Pons; D. Redó; N. Rodón; G. Rodríguez-Froxán; A. Santamaría; C. Sitges; N. Stasi; J.M. Soler; A. Torrens; M. Vaqué; L. Ventura; C. Vericat; A. Vila
• Keywords: Aged, 80 and over; Male; SARS-CoV-2; COVID-19; Middle Aged; 3. Good health; COVID-19 Drug Treatment; Hospitalization; Oxygen; Tertiary Care Centers; 03 medical and health sciences; Logistic Models; 0302 clinical medicine; Spain; Multivariate Analysis; Humans; Original Article; Female; Prospective Studies; Survivors; Lung; Aged; Follow-Up Studies

Few data are available regarding follow up of patients with coronavirus disease 2019 (COVID-19) after their discharge. We aim to describe the long-term outcomes of survivors of hospitalization for COVID-19 followed up first at an outpatient facility and subsequently by telephone.Observational prospective study conducted at a tertiary general hospital. Clinical and radiological progression was assessed and data were recorded on a standardized reporting form. Patients were divided into three groups according to Pao2/Fio2 at hospitalization: Pao2/Fio2 >300, Pao2/Fio2 300-200 and Pao2/Fio2 <200. A logistic multivariate regression model was performed to identify factors associated with persistence of symptoms.For facility follow up, 302 individuals were enrolled. Median follow up was 45 days after discharge; 78% (228/294) of patients had COVID-19-related symptoms (53% asthenia, 56% respiratory symptoms) and 40% (122/302) had residual pulmonary radiographic lesions. Pao2/Fio2 <200 was an independent predictor of persistent dyspnoea (OR 1.87, 95% CI 1.38-2.52, p < 0.0001). Pao2/Fio2 >300 was associated with resolution of chest radiographic lesions (OR 0.56, 95% CI 0.42-0.74, p < 0.0001). Fifty per cent of patients required specific medical follow up after the first consultation and were transferred to another physician. A total of 294 patients were contacted for telephone follow up after a median follow-up time of 7 months. Fifty per cent of patients (147/294) still presented symptoms and 49% (145/294) had psychological disorders. Asthenia was identified in 27% (78/294) and dyspnoea in 10% (28/294) of patients independently of Pao2/Fio2.Patients with COVID-19 require long-term follow up because of the persistence of symptoms; patients with low Pao2/Fio2 during the acute illness require special attention.