Introduction

To better define COVID-19 long-term impact we prospectively analysed patient-centred outcomes, including general health and symptom duration.

Methods

Barthel index (BI), St. George’s Respiratory Questionnaire adapted to patients with COVID-19 (aSGRQ) and WHO Clinical Progression Scale (CPS) were measured at enrolment and at 6 weeks from the onset of symptoms. Persistence of most frequently reported symptoms was assessed at 6 weeks and, among symptomatic patients, at 12 weeks from the onset of symptoms. Predictors of impaired general health over time were identified using an ordinal multilevel multivariate model.

Results

A total of 448 patients (55% men, median age 56 years) were enrolled. WHO-CPS showed mild, moderate and severe disease in 48%, 42% and 10% of patients at admission and mild disease in all patients at follow-up, respectively. BI and aSGRQ were normal in 96% and 93% patients before COVID-19 but only in 47% and 16% at COVID-19 diagnosis and in 87% and 65% at 6-week follow-up. Male gender was identified by all three assessments as a predictor of impaired general health (BI, OR 2.14, p < 0.0001; aSGRQ, OR 0.53, p = 0.003; WHO-CPS, OR 1.56, p = 0.01). Other predictors included age, ICU admission and comorbidities (e.g. cardiovascular disease and cancer) for BI, hospital admission for aSGRQ, age and presence of comorbidities for WHO-CPS. At 6- and 12-week follow-up, 39% and 20% of patients, respectively, were still reporting symptoms. Fatigue and breathlessness were the most frequently reported symptoms.

Conclusions

Long-term follow-up facilitates the monitoring of health impairment and symptom persistence and can contribute to plan tailored interventions.

中文翻译：

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在 COVID-19 患者的前瞻性队列中进行以患者为中心的长期随访

介绍

为了更好地定义 COVID-19 的长期影响，我们前瞻性地分析了以患者为中心的结果，包括总体健康状况和症状持续时间。

方法

Barthel 指数 (BI)、适用于 COVID-19 患者的圣乔治呼吸问卷 (aSGRQ) 和 WHO 临床进展量表 (CPS) 在入组时和症状出现后 6 周进行测量。最常报告的症状的持续性在 6 周时进行评估，在有症状的患者中，在症状出现后的 12 周进行评估。使用有序多级多变量模型确定随着时间的推移一般健康受损的预测因素。

结果

共招募了 448 名患者（55% 为男性，中位年龄 56 岁）。WHO-CPS 在入院时分别显示 48%、42% 和 10% 的患者为轻度、中度和重度疾病，在随访时所有患者为轻度疾病。在 COVID-19 之前，96% 和 93% 的患者的 BI 和 aSGRQ 正常，但在 COVID-19 诊断时仅为 47% 和 16%，在 6 周随访时分别为 87% 和 65%。所有三项评估都将男性确定为一般健康受损的预测因子（BI，OR 2.14，p  < 0.0001；aSGRQ，OR 0.53，p  = 0.003；WHO-CPS，OR 1.56，p = 0.01）。其他预测因素包括年龄、入住 ICU 和 BI 的合并症（例如心血管疾病和癌症）、aSGRQ 的入院率、WHO-CPS 的年龄和合并症的存在。在 6 周和 12 周的随访中，分别有 39% 和 20% 的患者仍报告有症状。疲劳和呼吸困难是最常报告的症状。

结论

长期随访有助于监测健康损害和症状持续存在，并有助于制定量身定制的干预措施。