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COVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge

Authors
  • Fortini, Alberto1
  • Torrigiani, Arianna1
  • Sbaragli, Serena1
  • Lo Forte, Aldo1
  • Crociani, Andrea1
  • Cecchini, Paolo2
  • Innocenti Bruni, Giulia3
  • Faraone, Antonio1
  • 1 Internal Medicine, San Giovanni di Dio Hospital, Via di Torregalli 3, 50143 Florence, Italy
  • 2 Emergency Department, San Giovanni di Dio Hospital, Florence, Italy
  • 3 San Giovanni di Dio Hospital, Florence, Italy
Type
Published Article
Journal
Infection
Publisher
Springer-Verlag
Publication Date
Jun 06, 2021
Pages
1–9
Identifiers
DOI: 10.1007/s15010-021-01638-1
PMID: 34091869
PMCID: PMC8179958
Source
PubMed Central
Keywords
Disciplines
  • Original Paper
License
Unknown

Abstract

Purpose Few data are currently available on persistent symptoms and late organ damage in patients who have suffered from COVID-19. This prospective study aimed to evaluate the results of a follow-up program for patients discharged from a nonintensive COVID-19 ward. Methods 3–6 months after hospital discharge, 59 of 105 COVID-19 patients (31 males, aged 68.2 ± 12.8 years) were recruited in the study. Forty-six patients were excluded because of nontraceability, refusal, or inability to provide informed consent. The follow-up consisted of anamnesis (including a structured questionnaire), physical examination, blood tests, ECG, lower limb compression venous ultrasound (US), thoracic US, and spirometry with diffusion lung capacity for carbon monoxide (DLCO). Results 22% of patients reported no residual symptoms, 28.8% 1 or 2 symptoms and 49.2% 3 or more symptoms. The most frequently symptoms were fatigue, exertional dyspnea, insomnia, and anxiety. Among the inflammatory and coagulation parameters, only the median value of fibrinogen was slightly above normal. A deep vein thrombosis was detected in 1 patient (1.7%). Thoracic US detected mild pulmonary changes in 15 patients (25.4%), 10 of which reported exertional dyspnea. DLCO was mildly or moderately reduced in 19 patients (37.2%), 13 of which complained of exertional dyspnea. Conclusion These results highlight that a substantial percentage of COVID-19 patients (77.8%) continue to complain of symptoms 3–6 months after hospital discharge. Exertional dyspnea was significantly associated with the persistence of lung US abnormalities and diffusing capacity alterations. Extended follow-up is required to assess the long-term evolution of postacute sequelae of COVID-19.

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