POST-COVID-19 SYNDROME: CHARACTERIZATION OF A COHORT AND ASSOCIATION WITH ACUTE DISEASE SEVERITY

Abstract

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: Post-COVID syndrome is defined as signs and symptoms that develop during or after COVID-19, continue for more than 12 weeks, not explained by other diagnosis. Symptoms are variable and involve any organ system1. The syndrome and risk factors are still under investigation. This study aimed to describe symptoms present at 2 and 6-month follow-up of patients with COVID-19 discharged from a tertiary hospital in Brazil and investigate association of post-COVID syndrome with severity of acute illness. METHODS: This is an observational study. Demographic characteristics and data from hospital admission were obtained through review of medical records. Patients that were admitted to Clementino Fraga Filho University Hospital with laboratory confirmed COVID-19 from March to December, 2020 were eligible to follow-up at the Post-COVID outpatient clinic. Appointments were scheduled 2 and 6 months after discharge. Symptoms and limitations were obtained. Patients were stratified into groups based on severity of acute phase: mild, moderate, severe pneumonia and critical disease2. RESULTS: 90 patients were included in the 2-month and 67 in the 6-month assessment. Average age was 60y and 52,2% were female. 24 patients had pneumonia, 52 severe pneumonia and 14 critical disease. There were no differences between groups regarding sex, age or comorbidities. At admission, patients with severe and critical disease had higher prevalence of cough (p=0.001) and dyspnea (p<0.001). Dyspnea on admission was associated with higher risk of severe or critical disease (RR = 4.207;CI 2.03-8.68). Length of hospital stay was longer and use of corticosteroids was more frequent with increased severity (p= 0.001). At 2-month follow-up, the most common symptoms were dyspnea (55,6%), fatigue (51,1%) and muscle weakness (50%). Anxiety was present in 47,8%. Fatigue was more frequent in patients with critical when compared to severe disease (78.6x40.4%, p = 0.01). This finding was associated with greater corticosteroid use in critical patients. Cough was more common in groups with greater severity (p = 0.01). All critical patients reported some or severe limitation to daily activities. At 6-month follow-up, dyspnea persisted in 47%, fatigue 50% and muscle weakness 40,9%. There was no difference in prevalence of symptoms between groups except for cough that was most seen in critical disease group (p = 0.01). CONCLUSIONS: We observed high prevalence of symptom persistence even 6 months after hospital discharge, remarkably dyspnea, fatigue and muscle weakness. The presence of symptoms was associated with acute disease severity at 2, but not at 6-month follow-up. CLINICAL IMPLICATIONS: Post-COVID syndrome is a new clinical entity that lacks research and better understanding of predisposing and maintenance factors. Long-term follow-up after COVID infection is necessary. DISCLOSURES: No relevant relationships by Marcos Bethlem, source=Web Response No relevant relationships by Michelle Cailleaux-Cezar, source=Web Response No relevant relationships by Fabio Kunita, source=Web Response No relevant relationships by Fernanda Oliveira Baptista da Silva, source=Web Response No relevant relationships by Bianca Peixoto, source=Web Response No relevant relationships by Nina VISCONTI, source=Web Response