ABSTRACT
Purpose of Study As of October of 2021, there have been over 43 million cases of COVID-19 and nearly 700,000 deaths in the U.S. alone. Many of those who have survived COVID-19 have been left with long-lasting symptoms such as fatigue, dyspnea, loss of smell or taste, and depression or anxiety. Mechanisms for these lasting symptoms are not fully known, so monitoring of patients after their infection has been cleared is important to determine both the rates and the mechanisms of the aptly named 'Long COVID.' The purpose of our study was to monitor the status of COVID-19 patients that were previously hospitalized at the UMC Medical Center in Lubbock, Texas after discharge. Methods Used We conducted a comprehensive chart review of 128 patients that were hospitalized for COVID-19 at any time between April 1, 2020 and April 1, 2021, and reviewed follow- up data for these patients after discharge. Summary of Results In our cohort of patients, 46% (n = 59) were men and 54% were women (n = 69) with an average age of 59.7 ± 14.8 years old. 60.9% of patients identified their race as Hispanic or of Latino origin (n = 78), with the next largest group being Caucasian at 22.65% (n = 29). The average number of days until post-hospitalization follow-up was 36 ± 38 days. Notable findings included a 50% rate of telehealth follow-up (n = 64), a 65.6% (n = 84) rate of diabetes, and a 73.4% (n = 94) rate of hypertension. 26.56% (n = 34) of patients reported respiratory symptoms at their follow- up appointments, 18.75% (n = 24) of patients reported constitutional symptoms, 9.37% (n = 12) of patients reported GI symptoms, and 19.5% (n = 25) of patients reported other symptoms such as paresthesia, lower extremity edema, or psychological symptoms. After discharge, 54 patients received follow- up X-rays. 75.9% (41/54) were found to still have abnormal findings consistent with COVID-19 imaging characteristics. During their follow-up appointment, 57 patients had a D-dimer lab value, 56 patients had a Ferretin value, and 59 patients had a Troponin T HS value. Of the follow-up patients with labs, 77.2% (44/57) had an elevated D-Dimer value, 78.6% (44/56) had an elevated Ferretin value, and 35.6% (21/59) had an elevated Troponin T HS value. Conclusions Our findings are consistent with pre-existing literature concerning higher rates of diabetes and hypertension in hospitalized COVID-19 patients, as well as reports of lasting symptoms after viral clearance. The CXR findings indicating lasting lung damage have some explanatory power in regard to respiratory symptoms at follow-up. Furthermore, our findings of elevated lab values in patients who received lab testing after discharge align with the emerging literature on D-dimer and Long COVID. Our lab findings should be considered limited due to pre-existing conditions or unrelated hospital visits that would predispose some these lab findings to be elevated. More research should be conducted to further elucidate mechanisms and treatment options for patients with Long COVID.
ABSTRACT
Purpose of Study It is understood that pregnant women are at higher risk for severe COVID-19 illness compared to nonpregnant people. Because of this, careful monitoring should be carried out. The purpose of this study was to identify the clinical characteristics, neonatal outcomes, and population demographics of COVID-positive pregnant women admitted to UMC Health Center in Lubbock, Texas. Methods Used We reviewed the charts of 35 pregnant patients with confirmed COVID-19 admitted to UMC Medical Center between April 12, 2020 and January 25, 2021. Results were reported with summative statistics such as mean and standard deviation along with percentages and counts for categorical values. Summary of Results The average patient age was 29 ± 4.8 years, and 71.43% of patients identified their ethnicity as Hispanic or Latino origin. Average length of stay was 3.33 ± 3.56 days, and average number of weeks at delivery was 37.79 ± 2.27 weeks. No deaths were reported among the mothers, but there were three pregnancies that did not result in live birth. Notable findings were an increased rate of preterm birth (18.18%), an increased rate of NICU admission (16.67%), and an increased rate of gestational diabetes (13.89%) compared to national averages among pregnant women. Conclusions Many of our findings confirmed the existing literature concerning pregnancy outcomes among COVID-19 positive pregnant women, including relatively high preterm birth and NICU admission rates. The number of women who identified their ethnicity as Hispanic or Latino was over-represented, which may be reflective of Lubbock's overall demographics or health inequities in West Texas. Furthermore, our gestational diabetes rate was higher than the national average, potentially reflective of Lubbock's high obesity rates. We recommend further research on the mechanisms of preterm birth in COVID-19 illness and ways to improve the health and healthcare equity of West Texas residents.