Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation

Stephen J Halpin, Claire McIvor, Gemma Whyatt, Anastasia Adams, Olivia Harvey, Lyndsay McLean, Christopher Walshaw, Steven Kemp, Joanna Corrado, Rajinder Singh, Tamsin Collins, Rory J O'Connor, Manoj Sivan, Stephen J Halpin, Claire McIvor, Gemma Whyatt, Anastasia Adams, Olivia Harvey, Lyndsay McLean, Christopher Walshaw, Steven Kemp, Joanna Corrado, Rajinder Singh, Tamsin Collins, Rory J O'Connor, Manoj Sivan

Abstract

Background: There is currently very limited information on the nature and prevalence of post-COVID-19 symptoms after hospital discharge.

Methods: A purposive sample of 100 survivors discharged from a large University hospital were assessed 4 to 8 weeks after discharge by a multidisciplinary team of rehabilitation professionals using a specialist telephone screening tool designed to capture symptoms and impact on daily life. EQ-5D-5L telephone version was also completed.

Results: Participants were between 29 and 71 days (mean 48 days) postdischarge from hospital. Thirty-two participants required treatment in intensive care unit (ICU group) and 68 were managed in hospital wards without needing ICU care (ward group). New illness-related fatigue was the most common reported symptom by 72% participants in ICU group and 60.3% in ward group. The next most common symptoms were breathlessness (65.6% in ICU group and 42.6% in ward group) and psychological distress (46.9% in ICU group and 23.5% in ward group). There was a clinically significant drop in EQ5D in 68.8% in ICU group and in 45.6% in ward group.

Conclusions: This is the first study from the United Kingdom reporting on postdischarge symptoms. We recommend planning rehabilitation services to manage these symptoms appropriately and maximize the functional return of COVID-19 survivors.

Keywords: SARS CoV-2; acute respiratory distress syndrome; post-COVID syndrome; post-intensive care syndrome.

© 2020 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.

References

REFERENCES

    1. Department of Health and Social Care. Number of Coronavirus (COVID-19) cases in the UK. . Accessed 8 July 2020.
    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-1242.
    1. Carfì A, Bernabei R, Landi F Gemelli Against. COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19 [published online ahead of print July 9, 2020]. JAMA. 2020:e2012603.
    1. Ahmed H, Patel K, Greenwood DC, et al. Long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS) outbreaks after hospitalisation or ICU admission: a systematic review and meta-analysis. J Rehabil Med. 2020;52:00063.
    1. NHS-England and NHS-Improvement. After-care needs of inpatients recovering from COVID-19. . Accessed 28 June 2020.
    1. Zhang G, Hu C, Luo L, et al. Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. J Clin Virol. 2020;127:104364.
    1. EuroQol. EQ-5D available upon request from
    1. World Health Organization (WHO). The International Classification of Functioning, Disability and Health. . Accessed 8 July 2020.
    1. Sivan M, Halpin SJ, Gee J. Assessing long-term rehabilitation needs in COVID-19 survivors using a telephone screening tool (C19-YRS tool). Adv Clin Neurosci Rehabil. 2020;19(4):14-17.
    1. Nolan CM, Longworth L, Lord J, et al. The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference. Thorax. 2016;71(6):493-500.
    1. Wootton DG, Dickinson L, Pertinez H, et al. A longitudinal modelling study estimates acute symptoms of community acquired pneumonia recover to baseline by 10 days. Eur Respir J. 2017;49:6.
    1. Wyrwich KW, Yu H, Sato R, Powers JH. Observational longitudinal study of symptom burden and time for recovery from community-acquired pneumonia reported by older adults surveyed nationwide using the CAP Burden of Illness Questionnaire [published online ahead of print July 30, 2020]. Patient Relat Outcome Meas. 2015;6:215-223.
    1. Wang X, Xu H, Jiang H, et al. The clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study [published online ahead of print May 22, 2020]. QJM. 2020:hcaa178.
    1. Islam MF, Cotler J, Jason LA. Post-viral fatigue and COVID-19: lessons from past epidemics [published online ahead of print May 31, 2020]. Fatigue Biomed Health Behav. 2020.
    1. Tansey CM, Louie M, Loeb M, et al. One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome. Arch Intern Med. 2007;167(12):1312-1320.
    1. Wu X, Dong D, Ma D. Thin-section computed tomography manifestations during convalescence and long-term follow-up of patients with severe acute respiratory syndrome (SARS). Med Sci Monit. 2016;22:2793-2799.
    1. Wade D, Hardy R, Howell D, Mythen M. Identifying clinical and acute psychological risk factors for PTSD after critical care: a systematic review. Minerva Anestesiol. 2013;79(8):944-963.
    1. Bajwah S, Wilcock A, Towers R, et al. Managing the supportive care needs of those affected by COVID-19. Eur Respir J. 2020;55:2000815.
    1. Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicentre study. Am J Gastroenterol. 2020;115(5):766-773.
    1. Fan E, Dowdy DW, Colantuoni E, et al. Physical complications in acute lung injury survivors: a 2-year longitudinal prospective study. Crit Care Med. 2014;42(4):849-859.
    1. Kamdar BB, Suri R, Suchyta MR, et al. Return to work after critical illness: a systematic review and meta-analysis. Thorax. 2020;75(1):17-27.
    1. Stam H, Stucki G, Bickenbach J. Covid-19 and post intensive care syndrome: a call for action. J Rehabil Med. 2020;52:jrm00044.
    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.
    1. Ong KC, Ng AW, Lee LS, et al. Pulmonary function and exercise capacity in survivors of severe acute respiratory syndrome. Eur Respir J. 2004;24(3):436-442.

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