» Articles » PMID: 34582728

Persistent Health Problems Beyond Pulmonary Recovery Up to 6 Months After Hospitalization for COVID-19: A Longitudinal Study of Respiratory, Physical, and Psychological Outcomes

Abstract

Data on longitudinal recovery after hospitalization for coronavirus disease (COVID-19) currently remain scarce, just as outcomes beyond 3 months of follow-up do. To evaluate the sequelae up to 6 months after hospitalization for COVID-19 by considering ) recovery as it relates to pulmonary function, radiological abnormalities, physical and mental health status, and health-related quality of life (HR-QoL) and ) the predictors of the most clinically relevant sequelae. Patients were evaluated at 6 weeks, 3 months, and 6 months after hospitalization by using pulmonary function testing, radiological evaluation, and online questionnaires on the physical and mental health status and HR-QoL. Outcomes were analyzed using repeated-measurement analyses. Ninety-two patients were included (mean age, 58.2 ± 12.3 yr; 58 [63.0%] men). The estimated percentage of patients with impaired forced vital capacity improved from 25% at 6 weeks to 11% at 6 months; for impaired diffusion capacity, this percentage improved from 63% to 46%. Radiologically, ground-glass opacity decreased but fibrosis persisted. The majority of patients (89.1%) still reported one or more symptoms 6 months after discharge. Fatigue decreased significantly over time ( = 0.006). Nonetheless, fatigue remained in 51% of the patients at 6 months. HR-QoL (nearly) normalized in most domains at 6 months, except for physical role functioning, with persistent fatigue and the length of hospitalization being the most important predictors. During the first 6 months after hospitalization for COVID-19, most patients demonstrated continuing recovery across all health domains, but persistent sequelae were frequent. Fatigue was the most frequent residual and persistent symptom up to 6 months after hospitalization, importantly impacting HR-QoL.

Citing Articles

Prevalence of depression, anxiety, stress, and suicide tendency among individual with long-COVID and determinants: A systematic review and meta-analysis.

Bidhendi-Yarandi R, Biglarian A, Karlstad J, Moe C, Bakhshi E, Khodaei-Ardakani M PLoS One. 2025; 20(1):e0312351.

PMID: 39874315 PMC: 11774403. DOI: 10.1371/journal.pone.0312351.


Mexican Hispanics show significant improvement in lung function approximately 1 year after having severe COVID-19.

Cortes-Telles A, Solis-Diaz L, Mateos-Toledo H, Guenette J, Zavorsky G Exp Physiol. 2024; 109(12):2147-2157.

PMID: 39446094 PMC: 11607618. DOI: 10.1113/EP091934.


Factors associated with cognitive impairment and the quality-of-life among COVID-19 survivors working as healthcare workers.

Sirait S, Sinaga B, Tarigan A, Wahyuni A Narra J. 2024; 4(1):e658.

PMID: 38798859 PMC: 11125409. DOI: 10.52225/narra.v4i1.658.


Pulmonary redox imbalance drives early fibroproliferative response in moderate/severe coronavirus disease-19 acute respiratory distress syndrome and impacts long-term lung abnormalities.

Yang C, Tan Y, Li Z, Hu L, Chen Y, Zhu S Ann Intensive Care. 2024; 14(1):72.

PMID: 38735020 PMC: 11089033. DOI: 10.1186/s13613-024-01293-3.


Association of pulmonary function test abnormalities and quality-of-life measures after COVID-19 infection.

Bradley J, Xu Q, Touloumes N, Lusciks E, Ali T, Huang E Am J Med Sci. 2024; 368(2):112-121.

PMID: 38636655 PMC: 11269026. DOI: 10.1016/j.amjms.2024.04.010.


References
1.
Wiersinga W, Rhodes A, Cheng A, Peacock S, Prescott H . Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA. 2020; 324(8):782-793. DOI: 10.1001/jama.2020.12839. View

2.
Halpin S, McIvor C, Whyatt G, Adams A, Harvey O, McLean L . Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. 2020; 93(2):1013-1022. DOI: 10.1002/jmv.26368. View

3.
Beom Park W, Jun K, Kim G, Choi J, Rhee J, Cheon S . Correlation between Pneumonia Severity and Pulmonary Complications in Middle East Respiratory Syndrome. J Korean Med Sci. 2018; 33(24):e169. PMC: 5990444. DOI: 10.3346/jkms.2018.33.e169. View

4.
George P, Wells A, Gisli Jenkins R . Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy. Lancet Respir Med. 2020; 8(8):807-815. PMC: 7228727. DOI: 10.1016/S2213-2600(20)30225-3. View

5.
Ackermann M, Verleden S, Kuehnel M, Haverich A, Welte T, Laenger F . Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med. 2020; 383(2):120-128. PMC: 7412750. DOI: 10.1056/NEJMoa2015432. View