ABSTRACT
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic affected many leading to higher mortality and morbidity worldwide. The post-COVID syndrome (PCS) is characterized by heterogeneous group of clinical manifestations which can frequently lead to a significant worsening in everyday life, working and social conditions. Methods: We prospectively examined in a cohort of patients discharged from our hospital "Saint Andrea”, Vercelli, Italy, from 10th March 2020 to 15th January 2021, with COVID-19 diagnosis during the first wave of pandemic the prevalence and characteristics of PCS after 2 years of follow-up. Results: Overall included patients were 306;prevalence of PCS after 2 years was 43.8%;the fatigue assessment scale (FAS) evidenced that only 8.5% of patients suffered from a severe fatigue with important limitations. Most frequently observed symptoms/conditions were: fatigue (38.2%), breathlessness (19.3%), "brain fog” (29.7%), sleeping disorders (28.8%), post-traumatic stress disorder (29.4%), anxiety (39.9%);only 7.2% of patients resumed the work without limitations or rest period. In multivariate analysis intensive care unit (ICU) admission [odds ratio (OR) =3.950;95% confidence interval (CI): 2.466–8.112;P=0.002], length of hospitalization (OR =1.855;95% CI: 1.248–5.223;P=0.004) and nosocomial infections (OR =2.556;95% CI: 1.443–5.292;P<0.001) were predictive of PCS at 2 years in the study population. Conclusions: After 2 years of follow-up, the 43.8% of enrolled subjects suffered from the PCS, but only the 8.5% with severe limitations in everyday life. We expect these data to highlight the importance of clinical and non-clinical aspect following the PCS in hospitalized patients. © Journal of Public Health and Emergency. All rights reserved.
ABSTRACT
BACKGROUND: The definition of 'long-COVID syndrome' (LCS) is still debated and describes the persistence of symptoms after viral clearance in hospitalized or non-hospitalized patients affected by coronavirus disease 2019 (COVID-19). AIM: In this study, we examined the prevalence and the risk factors of LCS in a cohort of patients with previous COVID-19 and followed for at least 6 months of follow-up. DESIGN: We conducted a prospective study including all hospitalized patients affected by COVID-19 at our center of Infectious Diseases (Vercelli, Italy) admitted between 10 March 2020 and 15 January 2021 for at least 6 months after discharge. Two follow-up visits were performed: after 1 and 6 months after hospital discharge. Clinical, laboratory and radiological data were recorded at each visit. RESULTS: A total of 449 patients were included in the analysis. The LCS was diagnosed in 322 subjects at Visit 1 (71.7%) and in 206 at Visit 2 (45.9); according to the post-COVID-19 functional status scale we observed 147 patients with values 2-3 and 175 with values >3 at Visit 1; at Visit 2, 133 subjects had the score between 2-3 and 73 > 3. In multivariate analysis, intensive care unit (ICU) admission (OR = 2.551; 95% CI = 1.998-6.819; P = 0.019), time of hospitalization (OR = 2.255; 95% CI = 1.018-6.992; P = 0.016) and treatment with remdesivir (OR = 0.641; 95% CI = 0.413-0.782; P < 0.001) were independent predictors of LCS. CONCLUSIONS: Treatment with remdesivir leads to a 35.9% reduction in LCS rate in follow-up. Severity of illness, need of ICU admission and length of hospital stay were factor associated with the persistence of PCS at 6 months of follow-up.