'Long-COVID': a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19

Swapna Mandal, Joseph Barnett, Simon E Brill, Jeremy S Brown, Emma K Denneny, Samanjit S Hare, Melissa Heightman, Toby E Hillman, Joseph Jacob, Hannah C Jarvis, Marc C I Lipman, Sindhu B Naidu, Arjun Nair, Joanna C Porter, Gillian S Tomlinson, John R Hurst, ARC Study Group, Aishah Ahmed, Asia Ahmed, Andrea Bangay, Izumi Barbor, Meg Barber, James Batty, Thea Buchan, Tom Burns, Alisha Chauhan, Roise Dudley, Ben Cooper, Mark Duncan, Nada Elsaid, Rebecca Evans, Samuel Flatau, Lydia Gabriel, James Goldring, Heather Groombridge, Liam Healy, Neel Jain, Afshan Khan, Camila Nagoda Niklewicz, Ezgi Ozcan, Preena Patel, Shivani Patel, Alexander Procter, Alice Ring, James Robertson, Portia Sagoe, Anita Saigal, George Seligmann, Runil Shah, Magali Taylor, Andrew Wendruff, Hannah Woodcock, Swapna Mandal, Joseph Barnett, Simon E Brill, Jeremy S Brown, Emma K Denneny, Samanjit S Hare, Melissa Heightman, Toby E Hillman, Joseph Jacob, Hannah C Jarvis, Marc C I Lipman, Sindhu B Naidu, Arjun Nair, Joanna C Porter, Gillian S Tomlinson, John R Hurst, ARC Study Group, Aishah Ahmed, Asia Ahmed, Andrea Bangay, Izumi Barbor, Meg Barber, James Batty, Thea Buchan, Tom Burns, Alisha Chauhan, Roise Dudley, Ben Cooper, Mark Duncan, Nada Elsaid, Rebecca Evans, Samuel Flatau, Lydia Gabriel, James Goldring, Heather Groombridge, Liam Healy, Neel Jain, Afshan Khan, Camila Nagoda Niklewicz, Ezgi Ozcan, Preena Patel, Shivani Patel, Alexander Procter, Alice Ring, James Robertson, Portia Sagoe, Anita Saigal, George Seligmann, Runil Shah, Magali Taylor, Andrew Wendruff, Hannah Woodcock

Abstract

Large numbers of people are being discharged from hospital following COVID-19 without assessment of recovery. In 384 patients (mean age 59.9 years; 62% male) followed a median 54 days post discharge, 53% reported persistent breathlessness, 34% cough and 69% fatigue. 14.6% had depression. In those discharged with elevated biomarkers, 30.1% and 9.5% had persistently elevated d-dimer and C reactive protein, respectively. 38% of chest radiographs remained abnormal with 9% deteriorating. Systematic follow-up after hospitalisation with COVID-19 identifies the trajectory of physical and psychological symptom burden, recovery of blood biomarkers and imaging which could be used to inform the need for rehabilitation and/or further investigation.

Keywords: respiratory infection; viral infection.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Patient reported breathlessness (0-10 scale) versus time of follow-up from hospital discharge. Each circle represents an individual patient at follow-up, with interpolation line and 90%CI. A higher score represents more severe breathlessness.

References

    1. Carfì A, Bernabei R, Landi F. for the Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. doi: 10.1001/jama.2020.12603. Published online July 09 2020.
    1. Mo X, Jian W, Su Z, et al. Abnormal pulmonary function in COVID-19 patients at time of hospital discharge [published online ahead of print, 2020 May 12] Eur Respir J. 2020;55(6):2001217. doi: 10.1183/13993003.01217-2020.
    1. Wei J, Yang H, Lei P, et al. Analysis of thin-section CT in patients with coronavirus disease (COVID-19) after hospital discharge. J Xray Sci Technol. 2020;28(3):383–389. doi: 10.3233/XST-200685.
    1. British Society of Thoracic Imaging COVID-19 chest x-ray classification. [last accessed August 24th 2020]. Available at: .
    1. Iba T, Levy JH, Levi M, Thachil J. Coagulopathy in COVID-19 [published online ahead of print, 2020 Jun 18] J Thromb Haemost. 2020 doi: 10.1111/jth.14975. 10.1111/jth.14975.
    1. Hui DS, Joynt GM, Wong KT, et al. Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax. 2005;60(5):401–409. doi: 10.1136/thx.2004.030205.
    1. Halpin SJ, McIvor C, Whyatt G, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation [published online ahead of print, 2020 Jul 30] J Med Virol. 2020 doi: 10.1002/jmv.26368. 10.1002/jmv.26368.

Source: PubMed

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