Long-term COVID-19 Complications and Relevant Outcomes in Severe COVID-19 Survivors

Abstract

Background: Long-term lung sequelae in patients who survived after severe COVID-19 are not clear. This study aims to evaluate complications and relevant outcomes of COVID-19 survivors within 6 months follow-up after discharge from the hospital. Methods: This study is a cohort of 50 patients with severe COVID-19 hospitalized in the intensive care unit (ICU) in 2020-2021 at Shahid Beheshti Hospital, Qom, Iran. The nasopharyngeal swab and reverse- transcription real-time PCR (RT-qPCR) assay were used to confirm COVID-19 in subjects. We used a checklist that compared symptoms, laboratory findings, and lung radiograph findings for patients at the time of admission and within 6 months follow-up after discharge from the hospital. The chest CT scans were used to verify lung involvement. The renal and liver function were assessed using alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), blood urea nitrogen (BUN), creatinine (Cr), and bilirubin. Results: 50 patients out of 384 participants who were hospitalized with severe COVID-19 were followed up within 6 months after discharge from the hospital. Findings revealed that, during the followup period, all clinical symptoms, except GI bleeding (p = 0.155), were significantly lower than the admission time (p < 0.001). Also, the mean of laboratory findings, including lymphocyte, neutrophil, lactate dehydrogenase, international normalized ratio, prothrombin, partial thromboplastin time, ESR, and CRP, were significantly lower than admission time (p < 0.001). Also, the mean of alanine transaminase (ALT) and aspartate aminotransferase (AST) between the admission and discharge time were significantly different (p < 0.001). Within 6 months of follow-up after discharge, the frequency of ground glass opacities, crazy paving, consolidation, spider web sign, and vascular thickening were significantly lower than in the admission time. Conclusion: Our findings revealed that among severe COVID-19 survivors, liver outcomes, inflammation, and clinical factors returned to normal range within 6 months of follow-up after discharge from the hospital. Also, during this period, the radiological findings were significantly lower than in the admission time.