"A Switch Went off in my Whole Body": Lived Experiences of Fatigue and Post-Exertional Malaise in Long Covid

The growing HCI agenda on health has focused on different chronic conditions but less so on Long Covid, despite its severe impact on the quality of life. We report findings from 2 workshops with 13 people living with Long Covid, indicating the challenges of making sense of their physical, cognitive, and emotional symptoms, and of monitoring the triggers of post-exertional malaise. While most participants engage in pacing activities for the self-management of fatigue, only a few are aware of the importance of planning all their daily activities and routines in order to avoid post-exertional malaise. We conclude with design implications to support lightweight tracking and sensemaking of fatigue symptoms, novel data analytics for monitoring the triggers of post-exertional malaise and the worsening of symptoms, and support for self-management in order to prevent post-exertional malaise. © 2023 Owner/Author.

Heart Rate Variability during Virtual Reality Activity in Individuals after Hospitalization for COVID-19: A Cross-Sectional Control Study

(1) Background: COVID-19 can lead to many complications, including cardiorespiratory complications and dysautonomia. This can be assessed by heart rate variability (HRV), which reflects the autonomic nervous system. There are different possibilities for physical rehabilitation after COVID, one of which that has been growing fast is the use of Virtual reality (VR) for rehabilitation. VR may represent an innovative and effective tool to minimize deficits that could lead to permanent disabilities in patients of outpatient rehabilitation services. The aim of this protocol is to establish whether practicing a task using a VR game with body movements influences physiological variables, such as heart rate, HRV, oxygen saturation, blood pressure, and perceptual variables during exercise in individuals post-hospitalization for COVID. (2) Methods: This cross-sectional study evaluated individuals divided into two groups, a post-hospitalization for COVID-19 group and a healthy control group. Subjects underwent one session of a VR task, and physiological variables, including HRV, were measured during rest, VR activity, and recovery. In addition, considering the influence of age in HRV and the impact of COVID-19, we divided participants by age. (3) Results: In all HRV indices and in both groups, an increase in sympathetic and a decrease in parasympathetic activity were found during VR. Additionally, the older post-COVID-19 group performed worse in non-linear indices, peripheral oxygen saturation, and rating of perceived exertion (RPE). (4) Conclusions: The VR game positively affects physiological variables and can therefore be utilized as a secure physical activity in both healthy individuals and individuals after hospitalization for COVID-19. COVID-19 affects the autonomic nervous system of older patients' post-hospitalization, which may be partly due to a higher BMI and the reduced exercise capacity in this population, affecting their ability to perform exercise activities. Other important observations were the higher RPE in COVID-19 patients during and after exercise, which may reflect altered physiological and autonomic responses. Taken together with the high reporting of fatigue after COVID-19, this is an important finding, and considering that RPE is usually lower during VR exercise compared to non-VR strengthens the potential for the use of VR in COVID-19 patients.

Physical activity and coronavirus disease 2019 (COVID-19): specific recommendations for home-based physical training

The novel coronavirus disease 2019 (COVID-19) seems to be having a major impact on physical activity behaviours globally. The pandemic has forced many people around the world to stay at home and self-isolate for a period of time. WHO recommends 60 min/day of moderate-to-vigorous physical activity for 6–17-yr-olds, and 75 min/wk of vigorous or 150 min/wk of moderate physical activity for adults and elderly, including 3 and 2 days/wk, respectively, with muscle and bone strengthening. Practical recommendations for staying active at home, with aerobic exercise training on a bike or rowing ergometer, bodyweight training, dance and active video gaming, can aid to counteract the detrimental physical and mental side-effects of the COVID-19 protective lifestyle regulations. This commentary provides useful information on home-based physical activity for sedentary people across the lifespan, including children and adolescence, that can be undertaken during the present pandemic or other outbreaks of infectious disease.

Post COVID-19 pulmonary complications in outpatient setting: Insights from a cross-sectional study in a rural academic hospital.

OBJECTIVE: Post COVID-19 disease pulmonary complications are generally expected among the hospitalized or elderly patients with multiple comorbidities given the gravity of the disease among such patients. However, non-hospitalized patients with less severe symptoms from COVID-19 disease have also been experiencing significant morbidity and difficulty functioning their activities of daily living. Therefore, we aim to characterize post COVID-19 pulmonary complications (symptomatology, clinical and radiological findings) in patients who did not require hospitalization but had significant outpatient visits secondary to COVID-19 sequelae. METHODS: This is a two part cross-sectional study based on a retrospective chart review. Patients with COVID-19 disease not requiring hospitalization but followed up at pulmonology clinic with respiratory symptoms were analyzed twice in an interval of 12 months. 23 patients in first cross-section group (followed up from December 2019 to June 2021) and 53 patients in second group (followed up from June 2021 to July 2022) were included in the analyses. Differences in mean and percentage of baseline characteristics and clinical outcomes between the two groups are analyzed using unpaired t-tests and Chi-squared tests respectively. Post COVID-19 disease symptoms are classified in to 3 different groups (mild, moderate and severe) based on duration of symptoms and presence or absence of hypoxia. RESULTS: Dyspnea on exertion (DOE) was the common compliant in majority of patients in both cross-section groups (43.5% vs 56.6%). Mean age in years were 33 and 50 in first and second cross-section groups respectively. Majority of the patients had mild and moderate symptoms in both groups (43.5% vs 9.4%, P = 0.0007; 43.5% vs 83%, P = 0.005). Mean duration of symptoms in first cross-section group was 3.8 whereas 10.5 months (P = 0.0001) in second cross-section group. CONCLUSION: Our study outlines the burden of post COVID-19 disease pulmonary complications in patient group where these complications are less expected. Strategies for the implementation of multidisciplinary post COVID-19 care clinic along with mass vaccination awareness campaigns in rural US should be prioritized to mitigate this existing burden.

Formation and Activation of a Healthy Lifestyle through Sports

The issues of globalization and the acceleration of developing scientific and technical progress, along with positive changes for humanity, have caused the emergence several problems related to ensuring a healthy lifestyle for the population, which are manifested in a decrease in physical activity, the spread of bad habits and a morbidity growth. Sport is one of the ways to solve these problematic issues. The purpose of the research is to substantiate the theoretical and applied principles of exploring sport as a component of the activation of a healthy lifestyle. The methodological base of the research consists of different methods of fundamental studies and economic analysis, namely: analysis, synthesis, comparative analysis, graphic method, generalization, and systematization. The results of the conducted research have made it possible to establish that sport is an integral component of activating a healthy lifestyle, contributing to the strengthening of immunity, ensuring the proper development of the human body and causing an increase in the rate of motor activity. The critical role of sports in the system of personality formation and socialization of individuals was revealed, as well as the main problems preventing a healthy lifestyle, namely: the COVID-19 pandemic, low level of popularization of a healthy lifestyle, low level of medical control over the health of the population, insufficient awareness of people about modern physical culture and health technologies and means of health promotion. The destructive impact of the COVID-19 pandemic and the low level of popularization of sports was proven. The main models of a healthy lifestyle were studied, including preventive, regulatory, physical, and psycho-regulatory, and a model of self-actualization and constructive thinking. The main ways of activating a healthy lifestyle have been proposed, among which a prominent place is given to sports, rational nutrition, correct daily routine and strengthening immunity.

Effect of using a structured pacing protocol on post-exertional symptom exacerbation and health status in a longitudinal cohort with the post-COVID-19 syndrome.

BACKGROUND: Post Exertional Symptom Exacerbation (PESE) is a characteristic symptom of Post-COVID Syndrome (PCS). OBJECTIVES: This prospective study investigated the effect of a 6-week structured World Health Organisation (WHO) Borg CR-10 5-phase pacing protocol on PESE episodes and quality of life in a cohort of individuals with long-standing PCS (average duration of symptoms was 17 months). METHODS: Participants received weekly telephone calls with a clinician to complete the Leeds PESE Questionnaire (LPQ) and identify the appropriate phase of the pacing protocol. EQ-5D 5L was completed at the intervention's beginning and end to measure overall health. RESULTS: Thirty-one participants completed the 6-week protocol, with a statistically and clinically significant reduction in the average number of PESE episodes (from 3.4 episodes in week one to 1.1 in week six), with an average decrease of 16% (95% CI: 9% to 24%; p<0.001) each week, and reduction across all three exertional triggers (physical, cognitive, and emotional). Physical activity levels showed moderate improvements during the intervention period. Mean EQ-5D 5L scores improved from 51.4 points to 60.6 points (paired difference of 9.2 points, 95% CI: 3.2 to 15.2 points; p=0.004). CONCLUSIONS: A structured pacing protocol significantly reduces PESE episodes and improves overall health in PCS. This article is protected by copyright. All rights reserved.

Effect of N95 filtering facepiece respirators on dental health professionals with an emphasis on pulmonary function and heart rate: an intrasubject comparison.

Despite the ubiquitous use of N95 filtering facepiece respirators (N95 FFR), published literature on the topic remains scarce, especially in relation to dental professionals. This study assesses the impact of N95 FFRs on blood oxygen saturation and heart rate of dental health professionals while performing procedures requiring varying degrees of physical exertion in an aerosol-rich environment. A total of 51 participants, consisting of 43 men and eight women aged between 23 and 31 years were recruited into the study. All subjects were well-versed in wearing personal protective equipment (PPE). A clinical grade pulse oximeter was used with a clamp placed around the fingertip or the earlobe of the participant. The selection of N95 FFR was based on fit and leakage. All data were collected once from the same participants using a surgical mask as a control. Data were collected again from the same subjects after 1, 2, and 3 hours of use. There were significant differences in both oxygen saturation (SpO2) and heart rate between the two groups after 1, 2, and 3 hours of wearing the respective masks. In healthy young individuals, wearing an N95 FFR for an extended period of time during clinical dental procedures reduced the SpO2level and increased the heart rate compared with a standard surgical mask. However, SpO2 levels remained within a healthy range of more than 95%, and heart rate was within acceptable limits.

The use of protective masks and the level of arterial oxygen saturation at rest and after exercise.

BACKGROUND: Studies of influenza, and human coronaviruses provide evidence that the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else. After global public health emergency of coronavirus SARS-CoV-2 causing illness of COVID-19 was changing frequency of wearing a mask. Therefore, study was undertaken to assess whether the use of protective masks affects the level of oxygen saturation during rest and during exercise. MATERIAL AND METHODS: The test consisted of a non-invasive measurement of oxygen saturation by percutaneous determination of arterial oxygen saturation with the use of the pulse oximeter. Oxygen saturation was measured during rest and after physical exertion performed without a protective mask (2 types of masks were used: surgical and FFP2), as well as during rest and after physical exertion performed with the use of a protective mask. The analysis of the oxygen saturation, heart rate, blood pressure and respiratory rate included data on 48 subjects. RESULTS: Comparing the post-exercise and pre-exercise values showed a significant difference between all of them. There were no differences found in any variables according to the mask/no-mask status. CONCLUSIONS: A short-term physical exercise performed in a group of healthy young people using protective masks did not affect oxygen saturation, heart rate, blood pressure and respiratory rate. Med Pr. 2022;73(4).

Perceived Exertion during Moderate and Vigorous Physical Activity While Mask Wearing: A Quantitative and Qualitative Pilot Study.

There is limited research examining the perception of exertion during exercise while wearing a facemask. The current study examined if mask usage during moderate or vigorous physical activity (MVPA) changed the self-reported perception of exertion. Seventy-two adults (18 years and older) who were physically active before the COVID-19 pandemic completed a questionnaire that assessed exercise habits and perceptions of mask wearing during MVPA. Participants reported their ratings of perceived exertion (RPE, on a scale of 1-10) while exercising. Wearing a mask resulted in higher RPE vs. no mask during both vigorous (8.4 ± 0.2 vs. 7.4 ± 0.1; p < 0.001) and moderate PA (6.6 ± 0.2 vs. 5.6 ± 0.2; p < 0.001). Qualitative analysis revealed mostly negative perceptions of exercising while wearing a mask, including respiratory issues, detriments to cardiovascular endurance, and general discomfort. A total of 40% of participants reported that they stopped exercising in an indoor/public setting because of a mask mandate in their region. Participants reported participating in less vigorous PA (4.7 ± 0.4 vs. 4.0 ± 0.4 h/week; p = 0.046), but not less moderate PA (3.3 ± 0.3 vs. 3.0 ± 0.3 h/week; p = 0.443) pre vs. during the pandemic. Our study suggests that facemask usage during MVPA causes an increase in RPE and may be one reason for a decrease in vigorous PA during the COVID-19 pandemic.

Perceived Exertion during Moderate and Vigorous Physical Activity While Mask Wearing: A Quantitative and Qualitative Pilot Study

There is limited research examining the perception of exertion during exercise while wearing a facemask. The current study examined if mask usage during moderate or vigorous physical activity (MVPA) changed the self-reported perception of exertion. Seventy-two adults (18 years and older) who were physically active before the COVID-19 pandemic completed a questionnaire that assessed exercise habits and perceptions of mask wearing during MVPA. Participants reported their ratings of perceived exertion (RPE, on a scale of 1–10) while exercising. Wearing a mask resulted in higher RPE vs. no mask during both vigorous (8.4 ± 0.2 vs. 7.4 ± 0.1;p < 0.001) and moderate PA (6.6 ± 0.2 vs. 5.6 ± 0.2;p < 0.001). Qualitative analysis revealed mostly negative perceptions of exercising while wearing a mask, including respiratory issues, detriments to cardiovascular endurance, and general discomfort. A total of 40% of participants reported that they stopped exercising in an indoor/public setting because of a mask mandate in their region. Participants reported participating in less vigorous PA (4.7 ± 0.4 vs. 4.0 ± 0.4 h/week;p = 0.046), but not less moderate PA (3.3 ± 0.3 vs. 3.0 ± 0.3 h/week;p = 0.443) pre vs. during the pandemic. Our study suggests that facemask usage during MVPA causes an increase in RPE and may be one reason for a decrease in vigorous PA during the COVID-19 pandemic.

Insights from Design Processes Used in Developing Exergames

Participation rates in physical activity are low, and with gyms closing and lockdowns becoming a necessary tool to fight the global pandemic, evidence suggests COVID-19 is only exacerbating the issue. People are becoming more sedentary as they stay at home longer and do more home office work. Exergames-games that require physical exertion to play-hold promise to combat sedentary behaviours, since they are typically inexpensive and can be played at home. Despite their potential to motivate people to move, it is challenging to design exergames because they must strike a balance between exercise and play. Current research in exergames provides some advice and guidelines on best practices for developing movement-based games. But, to date little attention has been given to the design processes that lead to the development of these guidelines. This paper aims to fill this gap by contributing 1) an in-depth discussion of and insights gained from the design process used when developing an exergame and 2) a novel movement-based method used in the development of a virtual reality (VR) exergame-VR bodystorming. We illustrate these methods through the development of Diverging Squash (DS), a novel VR squash game. We reveal insights throughout the entire design process from the beginning stages using brainstorming to focus on players' needs and motivation for physical activity, to using exertion cards for framing the game's primary elements. Exertion cards, for example, aided in our decision to gradually increase the difficulty of the game during play. We further demonstrate how our novel VR bodystorming method, or bodystorming in a virtual environment while wearing a VR headset, can be a useful tool for designers. For instance, during a VR bodystorming session, we practiced holding a virtual paddle in the VR environment in different ways. Insights from the way it was being held in VR led to adjustments to the way the paddle should be gripped, and the force needed to hit the ball. We conclude with key takeaways that give designers a view into how design methods for exergames are applied in practice and, thus, how they can be used in their own work.

SixFeet: An Interactive, Corona-Safe, Multiplayer Sports Platform

The global COVID-19 pandemic left few facets of our lives unchanged, including the possibility to play organised sports. Many gyms and sports clubs had to shut down due to social distancing measures, which resulted in reduced physical activity. Co-located group sports that promote social interaction and fun became almost impossible. This lack of physical interaction combined with social isolation and confinement have shown negative impacts on physical and mental well-being of people (for example, lack of motivation, anxiety, low immunity, low academic performance, negative mood and feelings) especially in children and young adults. Recent research therefore recommends exploring more creative approaches that allow physical activities during a pandemic, especially the ones that increase social interaction and engagement and allow users to share the same physical space. Towards this, we developed SixFeet, a novel digital-physical sports platform that allows its participants to play rigorous, collaborative sports-At a six feet distance. SixFeet ensures that the players are 1.5m away from each other at all times without them noticing it or without them having to worry about the social distancing measures. We developed a prototypical implementation of SixFeet and conducted a pilot study to evaluate its technical feasibility and practicality as well as obtain a first insight into user experience with the platform. Results show that participants never came within 1.5 meters of one another, felt connected nevertheless and were physically exerted. This paper presents the design and architecture of SixFeet, results of the preliminary user study, and a discussion on the versatility of SixFeet in accommodating training for different sports in times of a pandemic. © 2022 Owner/Author.

Proposal for assessment of the predominant symptom and physical function in patients suffering from Long COVID

Long COVID patients present a cluster of symptoms that overlaps with other post-infectious conditions, such as patients diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Besides fatigue, one of the most limiting clinical manifestations in ME/CFS is post-exertional malaise (PEM), which Long COVID patients also report. Therefore, there are concerns about treatment approaches in rehabilitation for long COVID patients. Up to date, Long COVID patients present fatigue and respiratory symptoms predominantly. The hypothesis presented in this paper is that the treatment approach for Long COVID patients may depend on the aetiology of their symptoms, which objective tests can assess. And the primary affected system in a given patient may determine the individual response to physical exhaustion. Then, we propose an assessment to confirm the system impaired under the predominant symptom to guide the rehabilitation intervention. Fatigue-related symptoms, PEM, physical deconditioning and response to exertion should be assessed in Long COVID patients with predominant fatigue. In contrast, the respiratory function by spirometry and the diffusion capacity should be objectively assessed in those patients with predominantly respiratory symptoms. Future research should develop and validate patient-reported outcomes or cardiopulmonary exercise testing to objectively assess the symptoms and functional status in Long COVID patients to reinforce the proposed assessment.

IDENTIFYING THE INTENSITY OF PHYSICAL ACTIVITY IN PHYSICAL EDUCATION AT SECONDARY SCHOOL DURING COVID-19

The current pandemic situation generated by COVID-19 demands the use of a mask to practise physical activity. The use of a mask requires that the intensity of such activity is not high. The Physical Education subject is essential to know how to determine the intensity of physical activity. The aim of this proposal is to teach students to identify the intensity of physical activity through the perception of their effort. This practical proposal, aimed at third-year secondary education students, consists of five activities to be carried out in eleven sessions. In conclusion, it is expected that students become aware of their own possibilities when facing physical activities with an adequate intensity. This ability to perceive and discriminate between intensities will help them to approach physical activity with a positive and healthy attitude.

Unlocking the Contradictory Outcomes of Presenteeism Through a Temporal Model: Effort Exertion as a Mediator.

The effects of presenteeism, that is, working while ill or exhausted, are unclear, as previous research has yielded contradictory results. The aim of this study was thus two-fold: clarify the differential effects of short versus long-term presenteeism and corroborate the mediating effect of effort exertion on the relationship between presenteeism and work-related outcomes. We adopt a three-wave panel design and measure all the variables at three different points (initially, after one week and after one year) to understand the effects of presenteeism over time. Our sample consists of 361 Chinese employees working in diverse industries in Taiwan. We analyze the panel data using structural equation modeling and bootstrapping. Our results reveal that presenteeism is positively associated with increased effort, work engagement, and job performance after one week. By contrast, presenteeism is negatively associated with job performance and work engagement though positively associated with emotional exhaustion after one-year. Our research contributes to clarify paradoxical results regarding presenteeism's consequences, as well as corroborating that effort exertion mediates the relationship between presenteeism and work outcomes. We also identify practical implications for organizations managing employees working remotely, a more common reality with the outbreak of the COVID-19 pandemic, the ensuing lockdowns and digitalization which has started to become the norm for a significant proportion of working sectors. Finally, we suggest recommendations for future research on presenteeism.

Effect of a facemask on heart rate, oxygen saturation, and rate of perceived exertion

The outbreak of the COVID-19 pandemic has led to severe restrictions and strict behavioral rules for daily life. To minimize the risk of infection, the wearing of facemasks is recommended in public areas, as well as in sports. Many people find this annoying or obstructive. The purpose of this study was to investigate the physiological effects of wearing a facemask during endurance exercise. A total of 16 male and 22 female subjects each completed two endurance runs of 15 minutes each, once with and once without a facemask, at the same speed. Heart rate and oxygen saturation were measured at the beginning and at the end of the two efforts and a classification of perceived exertion according to Borg was performed. Heart rate and Borg classification were significantly higher at the end of the exercise with mask (HR without mask: 151.4 ± 17.7 bpm;HR with mask: 156.4 ± 17.4 bpm;p = 0.009;Borg with mask: 12.9 ± 1.8;Borg without mask: 14.9 ± 1.6;p < 0.001). In contrast, the oxygen saturation shows no significant difference (SaO2 without mask: 96.9 ± 1.4 %;SaO2 with mask: 96.9 ± 1.3%;p = 0.814). The results suggest that wearing a facemask during steady-state exercise primarily has a negative effect on the subjective perception of exertion, and slightly on the heart rate. Despite the mask, however, the body is able to ensure uniform oxygen saturation in the blood. © 2021, Dynamic Media Sales Verlag. All rights reserved.

In-Season Body Composition Effects in Professional Women Soccer Players.

This study aimed to analyze anthropometric and body composition effects in professional soccer women players across the early and mid-competitive 2019/20 season. Seventeen players (age, height, body mass, and body mass index of 22.7 ± 6.3 years, 167.5 ± 5.6 cm, 60.7 ± 6.6 kg and 21.6 ± 0.2 kg/m2) from a Portuguese BPI League team participated in this study. The participants completed ≥80% of 57 training sessions and 13 matches. They were assessed at three points (before the start of the season (A1), after two months (A2), and after four months (A3)) using the following variables: body fat mass (BFM), soft lean mass (SLM), fat-free mass (FFM), intracellular water (ICW), extracellular water (ECW), total body water (TBW), and phase angle (PhA, 50 Khz), through InBody S10. Nutritional intake was determined through a questionnaire. Repeated measures ANCOVA and effect sizes (ES) were used with p < 0.05. The main results occurred between A1 and A2 for BFM (-21.7%, ES = 1.58), SLM (3.7%, ES = 1.24), FFM (4%, ES = 1.34), ICW (4.2%, ES = 1.41), TBW (3.7%, ES = 1.04). Furthermore, there were significant results between A1 and A3 for FFM (4.8%, ES = 1.51), ICW (5%, ES = 1.68), and PhA (10.4%, ES = 6.64). The results showed that the water parameters improved over time, which led to healthy hydration statuses. The training load structure provided sufficient stimulus for appropriate physical fitness development, without causing negative disturbances in the water compartments.

Facemasks and Walk Distance in Pulmonary Arterial Hypertension Patients.

Little is known about the effect of wearing a facemask on the physiological and perceptual responses to exercise in patients with pulmonary arterial hypertension (PAH). We performed a single-center retrospective study to evaluate whether facemask wearing impacted distanced covered, rating of perceived exertion (RPE), and arterial oxygen saturation (SpO2) during a 6-minute walk test (6MWT) in PAH patients. Forty-five patients being treated for group 1 PAH and who performed a 6MWT before and after implementation of a facemask mandate were included in the analysis. Each included patient performed a 6MWT without (test 1) and with (test 2) a facemask between October 1, 2019, and October 31, 2020. At both time points, all patients also underwent a submaximal cardiopulmonary exercise test, echocardiogram, and blood laboratory tests, with a Registry to Evaluate Early and Long-Term PAH Disease Management Lite 2.0 score calculated. The two 6MWTs were performed 81±51 days apart, and all patients were clinically stable at both testing timepoints. Six-minute walk test distance was not different between test 1 and test 2 (405±108 m vs 400±103 m, P=.81). Similarly, both end-test RPE and lowest SpO2 during the 6MWT were not different in test 1 and test 2 (RPE: 2.5±1.7 vs 2.5±2.1, P=.91; SpO2 nadir: 92.8±3.4% vs 93.3±3.3%, P=.55). Our findings show that wearing a facemask has no discernable impact on the arterial oxygen saturation and perceptual responses to exercise or exercise capacity in patients with moderate-to-severe PAH. This study reinforces the evidence that wearing a facemask is safe in PAH patients, even during exercise.

Lung Function and Symptoms in Post-COVID-19 Patients: A Single-Center Experience.

OBJECTIVE: To address the lack of information about clinical sequelae of coronavirus disease 2019 (COVID-19). PATIENTS AND METHODS: Previously hospitalized COVID-19 patients who were attending the outpatient clinic for post-COVID-19 patients (ASST Ovest Milanese, Magenta, Italy) were included in this retrospective study. They underwent blood draw for complete blood count, C-reactive protein, ferritin, D-dimer, and arterial blood gas analysis and chest high-resolution computed tomography (HRCT) scan. The primary endpoint was the assessment of blood gas exchanges after 3 months. Other endpoints included the assessment of symptoms and chest HRCT scan abnormalities and changes in inflammatory biomarkers after 3 months from hospital admission. RESULTS: Eighty-eight patients (n = 65 men; 73.9%) were included. Admission arterial blood gas analysis showed hypoxia and hypocapnia and an arterial partial pressure of oxygen/fractional inspired oxygen ratio of 271.4 (interquartile range [IQR]: 238-304.7) mm Hg that greatly improved after 3 months (426.19 [IQR: 395.2-461.9] mm Hg, P<.001). Forty percent of patients were still hypocapnic after 3 months. Inflammatory biomarkers dramatically improved after 3 months from hospitalization. Fever, resting dyspnea, and cough were common at hospital admission and improved after 3 months, when dyspnea on exertion and arthralgias arose. On chest HRCT scan, more than half of individuals still presented with interstitial involvement after 3 months. Positive correlations between the interstitial pattern at 3 months and dyspnea on admission were found. C-reactive protein at admission was positively associated with the presence of interstitial involvement at follow-up. The persistence of cough was associated with presence of bronchiectasis and consolidation on follow-up chest HRCT scan. CONCLUSION: Whereas inflammatory biomarker levels normalized after 3 months, signs of lung damage persisted for a longer period. These findings support the need for implementing post-COVID-19 outpatient clinics to closely follow-up COVID-19 patients after hospitalization.