ABSTRACT
Introduction: Symptoms after covid are common. The clinical manifestation of long-covid was't described completely for the long term period. Aim(s): The aim was to describe veariety of patient's symptoms at least 4months after infection. Method(s): a)prepare questionnaire items;b)selection of relevant items;c)formal adjustment;d)pilot verification on 50pts;e)modification of the structure of questions;f)performing an exploratory factor analysis. Result(s): We enrolled 703consecutive pts(352 males;53+/-15yrs;BMI 29+/-5;222+/-112days from diagnosis)from Mar21 to Jan22. Two-fifths(272pts;39%)of them were initialy hospitalized due to covid. Eight clusters of long-covid symptoms/manifestations(s/m)were identified: respiratory+fatigue cluster;musculo-skeletal c.;skin c.;psychical c.;recurrent infections c.;smell+taste c.;trombotic c;nefrological c.Elderly pts were more affected by musculoskeletal s/m;less frequently experienced psychical s/m;recurrent infection s/m;small+taste s/m.Obese pts reported more frequently respiratory+fatigue s/m;musculo-skeletal s/m;thrombotic s/m;nephrological s/m. Educational level was not associated with the dominance of any s/m cluster. The Delta variant predisposed to the dominance of respiratory+fatigue s/m;musculo-skeletal s/m. Previously hospitalized suffered more frequently from musculo-skeletal s/m;trombotic s/m;less frequently from smell+taste s/m. Conclusion(s): Manifestation of long-covid symptoms is heterogeneous condition for many months after the initial diagnosis.
ABSTRACT
Results from RECOVERY trial showed effect of 6 mg of dexamethasone, despite it we observed high mortality. We therefore used higher than recommended doses of steroids in severe and rapidly progressive COVID patients in January 2021. In this study we retrospectively evaluated effect of total dose of given systemic steroids on mortality in 92 consecutively admitted patients in January 2021 for COVID pneumonia to Pulmonary Dept. of University Hospital. Average age was 70,6+/-12,8, 44 (47%) females, 48 (53%) males, average BMI 29,6+/-2,4, clinical frailty score 3,7+/-2,1, Charleson Comorbidity Index 4,0+/-3,3, average blood oxygen saturation od admittance was 88,0%+/-7,1, average breath rate 20,1+/-11, CRP 123,3+/-62,7 mg/L, average length of stay was 19,0+/-13,0. Totally 40 (43,5%) required an ICU care during the stay in the hospital. Mortality was 17,3% (16 of 93 patients died).). Length of the stay correlated to severity of the COVID according to WHO classification (p<0.001, R= 0.50). During the stay in the hospital 21 patients were dependent on HFNO (22,8%), 8 patients required NIV support (8,7%) and 8 (8,7%) patients were intubated. Systemic steroids were given to 85 patients (92,4%) patients. Average daily dose of steroids was 22,4 mg of dexamethasone (DX) (95%CI 16.2-28.6), mean total dose of DX per whole hospital stay was 212.5 mg (95%CI 152.4-272.1). Length of the stay who died was significantly longer (23.5 vs 15.1 days, p=0.01). We used significantly higher total dose of steroids in patients who later died on COVID (p<0.001). Average dose of total steroids given during hospital stay was 377 mg of dexamethasone (95%CI, 252-501) in those who died, and 172mg (95%CI, 106- 238). We did not observe clinical impact of high dose steroids on mortality of COVID pneumonia patients.