Abstract

Medical research is progressing to clarify the full spectrum of sub-acute and long-term effects of the post-COVID-19 syndrome. However, most manuscripts published to date only analyze the effects of post-COVID-19 in patients discharged from hospital, which may induce significant bias. Here, we propose a pioneering study to analyze the single and multiple associations between post-COVID-19 characteristics with up to 6-months of follow-up in hospitalized and non-hospitalized COVID-19 patients. The cohort study was conducted from May to October 2020 at the University Hospital Virgen de la Nieves, the leading hospital assigned for patients with COVID-19 in Granada, Spain. A total of 372 and 217 patients—with 217 and 207 included in the first and second follow-up visits—were referred 2 and 6 months after diagnosing COVID-19, respectively. We find out that post-COVID-19 clinical and mental health impairment symptoms are correlated with patient gender. Logistic adjustments showed strong statistically robust single and multiple associations of demographic, clinical, mental health, X-ray, laboratory indices, and pulmonary function variables. The functional lung tests are good predictors of chest CT imaging abnormalities in elderly patients. Bilateral lung involvement, subpleural reticulum, ground-glass opacity, peripheral lung lesions, and bronchiectasis were the most common findings of the high-resolution computed tomography images. Non-hospitalized patients suffer more severe thromboembolic events and fatigue than those hospitalized.

Highlights

  • Medical research is progressing to clarify the full spectrum of sub-acute and long-term effects of the post-COVID-19 syndrome

  • Similar persistent symptoms were reported in patients from previous coronavirus nfections—including the 2003 SARS epidemic and the 2012 Middle East Respiratory Syndrome (MERS)11–16—reinforcing concerns about post-COVID-19 syndrome (PCS)[17]

  • Active smokers or ex-smokers 89 (41%) with International Coalition Against Tobacco (ICAT) of 0[1–2]. 52.6% had been in contact with family members with suspected or confirmed COVID-19

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Summary

Introduction

Medical research is progressing to clarify the full spectrum of sub-acute and long-term effects of the post-COVID-19 syndrome. We propose a pioneering study to analyze the single and multiple associations between post-COVID-19 characteristics with up to 6-months of follow-up in hospitalized and non-hospitalized COVID-19 patients. Long-term effects on multiple organ systems, caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2)—pathogen of coronavirus disease 2019 (COVID-19)—is one of the current problems faced by patients after passing the ­disease[1–3]. Preliminary studies report persisting symptoms of SARS-CoV-2, such as fatigue, dyspnea, cognitive deficit, arthralgia, impaired lung functions, and abnormal chest i­mages[4–10]. The work of Ongsobre et al clearly shows the persistent and prolonged effects of lung function impairment one year after acquiring severe acute respiratory syndrome (SARS1)[15]. Current 12-, 6- and 3-month follow-up studies focus on persistent clinical, psychological, pulmonary function, physical problems, and chest CT imaging only for the discharged ­patients[8,10,24–29]. The association between pre-existing respiratory diseases and PCS is still unknown

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