Asthma may influence long-term consequences of COVID-19 in hospitalised adult

ABSTRACT

Background: The symptoms of the COVID-19 acute phase are well studied, but the long-term sequelae (post-COVID condition) are still poorly characterised. The aim of this study was to evaluate the prevalence of persistent symptoms in previously hospitalised adult patients with COVID-19 and assess risk factors for the post-COVID condition Method: Ambidirectional cohort study of patients over 18 years hospitalised to Sechenov University Hospital Network, Moscow, Russia with clinically diagnosed or laboratory-confirmed COVID-19 between April 8 and July 10, 2020. Study participants were interviewed 6-8 months after discharge via telephone using a follow-up case report form (CRF) developed by ISARIC in collaboration with WHO. Identified symptoms were categorised according to organ systems. Risk factors were assessed by multivariate logistic regression. Results: Among 4,755 patients discharged from the hospitals, 2,649 were subsequently interviewed. The median age of patients was 56 years (46-66), and 1,353 patients (51.1%) were female. The follow-up median time was 217.5 days (200.4-235.5). 1,247 (47.1%) participants reported persistent symptoms (since discharge). The most frequent symptoms were fatigue (21.2%, 551/2599), shortness of breath (14.5%, 378/2614) and forgetfulness (9.1%, 237/2597). Female gender was associated with chronic fatigue with an odds ratio of 1.67 (95% confidence interval 1.39-2.02), neurological 2.03 (1.60-2.58), mental 1.83 (1.41-2.40), respiratory 1.31 (1.06-1.62) and dermatological symptoms 3.26 (2.36-4.57), GI disturbances 2.50 (1.64-3.89) and sensory problems 1.73 (2.06-2.89). Pre-existing asthma was associated with a higher risk of neurological 1.95 (1.25-2.98) and mood and behavioural changes 2.02 (1.24-3.18). Conclusion: Six to eight months after COVID-19 nearly half of patients have symptoms lasting since discharge. The main risk factor for the majority of the development of long-term symptoms was female sex. Asthma may also serve as a risk factor for the post-COVID condition. Further follow-up of patients reporting the persistence of COVID-19 symptoms and the development of interventional approaches for the prevention of post-COVID manifestations are needed.