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Author(s):
Rosa María Wong-Chew ,
Edwin Xchel Rodríguez Cabrera ,
Carlos Alberto Rodríguez Valdez ,
Julieta Lomelin-Gascon ,
Linda Morales-Juárez ,
Mariana Lizbeth Rodríguez de la Cerda ,
Antonio Rafael Villa-Romero ,
Stephanie Arce Fernández ,
Mariana Serratos Fernandez ,
Héctor Herrera Bello ,
Lidia Moreno Castañeda ,
Mónica Arboleya Avendaño ,
Jesús Abraham Hernández-Cruz ,
Nelson Álvarez Martínez ,
Liza Fernanda Contreras ,
Luis Rafael González de la Cerda ,
Arturo Juárez Flores ,
Luis Alberto Martínez-Juarez ,
Diego-Abelardo Álvarez-Hernández ,
Héctor Gallardo-Rincón ,
German Fajardo Dolci ,
Roberto Tapia-Conyer ,
Rafael Ricardo Valdez-Vázquez
Publication date (Electronic): 11 January 2022
Journal: Therapeutic Advances in Infectious Disease
Publisher: SAGE Publications
Keywords: COVID-19, post COVID-19, long-covid, symptom cluster, Mexico
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Several reports have emerged describing the long-term consequences of COVID-19 and its effects on multiple systems. As further research is needed, we conducted a longitudinal observational study to report the prevalence and associated risk factors of the long-term health consequences of COVID-19 by symptom clusters in patients discharged from the Temporary COVID-19 Hospital (TCH) in Mexico City. Self-reported clinical symptom data were collected via telephone calls over 90 days post-discharge. Among 4670 patients, we identified 45 symptoms across eight symptom clusters (neurological; mood disorders; systemic; respiratory; musculoskeletal; ear, nose, and throat; dermatological; and gastrointestinal). We observed that the neurological, dermatological, and mood disorder symptom clusters persisted in >30% of patients at 90 days post-discharge. Although most symptoms decreased in frequency between day 30 and 90, alopecia and the dermatological symptom cluster significantly increased ( p < 0.00001). Women were more prone than men to develop long-term symptoms, and invasive mechanical ventilation also increased the frequency of symptoms at 30 days post-discharge. Abstract
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6-month consequences of COVID-19 in patients discharged from hospital: a cohort study
Chaolin Huang, Lixue Huang, Yeming Wang … (2021)
Background The long-term health consequences of COVID-19 remain largely unclear. The aim of this study was to describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity. Methods We did an ambidirectional cohort study of patients with confirmed COVID-19 who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7, 2020, and May 29, 2020. Patients who died before follow-up, patients for whom follow-up would be difficult because of psychotic disorders, dementia, or re-admission to hospital, those who were unable to move freely due to concomitant osteoarthropathy or immobile before or after discharge due to diseases such as stroke or pulmonary embolism, those who declined to participate, those who could not be contacted, and those living outside of Wuhan or in nursing or welfare homes were all excluded. All patients were interviewed with a series of questionnaires for evaluation of symptoms and health-related quality of life, underwent physical examinations and a 6-min walking test, and received blood tests. A stratified sampling procedure was used to sample patients according to their highest seven-category scale during their hospital stay as 3, 4, and 5–6, to receive pulmonary function test, high resolution CT of the chest, and ultrasonography. Enrolled patients who had participated in the Lopinavir Trial for Suppression of SARS-CoV-2 in China received severe acute respiratory syndrome coronavirus 2 antibody tests. Multivariable adjusted linear or logistic regression models were used to evaluate the association between disease severity and long-term health consequences. Findings In total, 1733 of 2469 discharged patients with COVID-19 were enrolled after 736 were excluded. Patients had a median age of 57·0 (IQR 47·0–65·0) years and 897 (52%) were men. The follow-up study was done from June 16, to Sept 3, 2020, and the median follow-up time after symptom onset was 186·0 (175·0–199·0) days. Fatigue or muscle weakness (63%, 1038 of 1655) and sleep difficulties (26%, 437 of 1655) were the most common symptoms. Anxiety or depression was reported among 23% (367 of 1617) of patients. The proportions of median 6-min walking distance less than the lower limit of the normal range were 24% for those at severity scale 3, 22% for severity scale 4, and 29% for severity scale 5–6. The corresponding proportions of patients with diffusion impairment were 22% for severity scale 3, 29% for scale 4, and 56% for scale 5–6, and median CT scores were 3·0 (IQR 2·0–5·0) for severity scale 3, 4·0 (3·0–5·0) for scale 4, and 5·0 (4·0–6·0) for scale 5–6. After multivariable adjustment, patients showed an odds ratio (OR) 1·61 (95% CI 0·80–3·25) for scale 4 versus scale 3 and 4·60 (1·85–11·48) for scale 5–6 versus scale 3 for diffusion impairment; OR 0·88 (0·66–1·17) for scale 4 versus scale 3 and OR 1·77 (1·05–2·97) for scale 5–6 versus scale 3 for anxiety or depression, and OR 0·74 (0·58–0·96) for scale 4 versus scale 3 and 2·69 (1·46–4·96) for scale 5–6 versus scale 3 for fatigue or muscle weakness. Of 94 patients with blood antibodies tested at follow-up, the seropositivity (96·2% vs 58·5%) and median titres (19·0 vs 10·0) of the neutralising antibodies were significantly lower compared with at the acute phase. 107 of 822 participants without acute kidney injury and with estimated glomerular filtration rate (eGFR) 90 mL/min per 1·73 m2 or more at acute phase had eGFR less than 90 mL/min per 1·73 m2 at follow-up. Interpretation At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery. Funding National Natural Science Foundation of China, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, and Peking Union Medical College Foundation.
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Persistent Symptoms in Patients After Acute COVID-19
Angelo Carfì, Roberto Bernabei, Francesco Landi (2020)
This case series describes COVID-19 symptoms persisting a mean of 60 days after onset among Italian patients previously discharged from COVID-19 hospitalization.
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Neurological associations of COVID-19
Mark Ellul, Laura Benjamin, Bhagteshwar Singh … (2020)
Summary Background The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is of a scale not seen since the 1918 influenza pandemic. Although the predominant clinical presentation is with respiratory disease, neurological manifestations are being recognised increasingly. On the basis of knowledge of other coronaviruses, especially those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome epidemics, cases of CNS and peripheral nervous system disease caused by SARS-CoV-2 might be expected to be rare. Recent developments A growing number of case reports and series describe a wide array of neurological manifestations in 901 patients, but many have insufficient detail, reflecting the challenge of studying such patients. Encephalopathy has been reported for 93 patients in total, including 16 (7%) of 214 hospitalised patients with COVID-19 in Wuhan, China, and 40 (69%) of 58 patients in intensive care with COVID-19 in France. Encephalitis has been described in eight patients to date, and Guillain-Barré syndrome in 19 patients. SARS-CoV-2 has been detected in the CSF of some patients. Anosmia and ageusia are common, and can occur in the absence of other clinical features. Unexpectedly, acute cerebrovascular disease is also emerging as an important complication, with cohort studies reporting stroke in 2–6% of patients hospitalised with COVID-19. So far, 96 patients with stroke have been described, who frequently had vascular events in the context of a pro-inflammatory hypercoagulable state with elevated C-reactive protein, D-dimer, and ferritin. Where next? Careful clinical, diagnostic, and epidemiological studies are needed to help define the manifestations and burden of neurological disease caused by SARS-CoV-2. Precise case definitions must be used to distinguish non-specific complications of severe disease (eg, hypoxic encephalopathy and critical care neuropathy) from those caused directly or indirectly by the virus, including infectious, para-infectious, and post-infectious encephalitis, hypercoagulable states leading to stroke, and acute neuropathies such as Guillain-Barré syndrome. Recognition of neurological disease associated with SARS-CoV-2 in patients whose respiratory infection is mild or asymptomatic might prove challenging, especially if the primary COVID-19 illness occurred weeks earlier. The proportion of infections leading to neurological disease will probably remain small. However, these patients might be left with severe neurological sequelae. With so many people infected, the overall number of neurological patients, and their associated health burden and social and economic costs might be large. Health-care planners and policy makers must prepare for this eventuality, while the many ongoing studies investigating neurological associations increase our knowledge base.
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Author and article information
Contributors
Rosa María Wong-Chew: Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Edwin Xchel Rodríguez Cabrera: Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Carlos Alberto Rodríguez Valdez: Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Julieta Lomelin-Gascon: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Linda Morales-Juárez: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Mariana Lizbeth Rodríguez de la Cerda: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Antonio Rafael Villa-Romero: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Stephanie Arce Fernández: Role: InvestigationRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Mariana Serratos Fernandez: Role: InvestigationRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Héctor Herrera Bello: Role: Project administrationRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Lidia Moreno Castañeda: Role: Project administrationRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Mónica Arboleya Avendaño: Role: Project administrationRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Jesús Abraham Hernández-Cruz: Role: InvestigationRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Nelson Álvarez Martínez: Role: InvestigationRole: Project administrationRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Liza Fernanda Contreras: Role: InvestigationRole: Project administrationRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Luis Rafael González de la Cerda: Role: Data curationRole: Formal analysisRole: SoftwareRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Arturo Juárez Flores: Role: Data curationRole: Formal analysisRole: SoftwareRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Luis Alberto Martínez-Juarez:
ORCID: https://orcid.org/0000-0001-7550-7867
Role: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Diego-Abelardo Álvarez-Hernández:
ORCID: https://orcid.org/0000-0003-2340-6639
Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Héctor Gallardo-Rincón:
ORCID: https://orcid.org/0000-0002-0811-4606
Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
German Fajardo Dolci: Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: Writing original draftRole: Writing review editing
Roberto Tapia-Conyer: Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Rafael Ricardo Valdez-Vázquez: Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing original draftRole: Writing review editing
Journal
Journal ID (nlm-ta): Ther Adv Infect Dis
Journal ID (iso-abbrev): Ther Adv Infect Dis
Journal ID (publisher-id): TAI
Journal ID (hwp): sptai
Title: Therapeutic Advances in Infectious Disease
Publisher: SAGE Publications (Sage UK: London, England )
ISSN (Print): 2049-9361
ISSN (Electronic): 2049-937X
Publication date (Electronic): 11 January 2022
Publication date Collection: Jan-Dec 2022
Volume: 9
Electronic Location Identifier: 20499361211069264
Affiliations
[20-20499361211069264]Carlos Slim Foundation, Mexico City, MexicoLondon School of Hygiene & Tropical Medicine, London, UK
[21-20499361211069264]Carlos Slim Foundation, Mexico City, MexicoLondon School of Hygiene & Tropical Medicine, London, UK
[22-20499361211069264]Health Sciences University Center, University of Guadalajara, Sierra Mojada 950, Independencia Oriente, 44340 Guadalajara, Jalisco, Mexico
Author notes
Author information
Luis Alberto Martínez-Juarez https://orcid.org/0000-0001-7550-7867
Diego-Abelardo Álvarez-Hernández https://orcid.org/0000-0003-2340-6639
Héctor Gallardo-Rincón https://orcid.org/0000-0002-0811-4606
Article
Publisher ID: 10.1177_20499361211069264
DOI: 10.1177/20499361211069264
PMC ID: 8764618
PubMed ID: 35059196
SO-VID: 80a66c86-04f5-46d1-9999-8a06326f1ddc
Copyright © © The Author(s), 2022
License:
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).
History
Date received : 17 September 2021
Date accepted : 7 December 2021
Categories
Subject: Original Research
Custom metadata
cover-date January-December 2022
typesetter ts1
Keywords: covid-19,post covid-19,long-covid,symptom cluster,mexico
Data availability:
Keywords: covid-19, post covid-19, long-covid, symptom cluster, mexico
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