Your browser doesn't support javascript.
Residual clinical damage after COVID-19: A retrospective and prospective observational cohort study.
De Lorenzo, Rebecca; Conte, Caterina; Lanzani, Chiara; Benedetti, Francesco; Roveri, Luisa; Mazza, Mario G; Brioni, Elena; Giacalone, Giacomo; Canti, Valentina; Sofia, Valentina; D'Amico, Marta; Di Napoli, Davide; Ambrosio, Alberto; Scarpellini, Paolo; Castagna, Antonella; Landoni, Giovanni; Zangrillo, Alberto; Bosi, Emanuele; Tresoldi, Moreno; Ciceri, Fabio; Rovere-Querini, Patrizia.
  • De Lorenzo R; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Conte C; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Lanzani C; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Benedetti F; Unit of Nephrology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Roveri L; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Mazza MG; Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Brioni E; Department of Neuroscience, INSPE, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Giacalone G; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Canti V; Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Sofia V; Unit of Nephrology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • D'Amico M; Department of Neuroscience, INSPE, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Di Napoli D; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Ambrosio A; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Scarpellini P; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Castagna A; Clinical Governance Division, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Landoni G; Clinical Governance Division, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Zangrillo A; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Bosi E; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Tresoldi M; Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
  • Ciceri F; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
  • Rovere-Querini P; Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
PLoS One ; 15(10): e0239570, 2020.
Article in English | MEDLINE | ID: covidwho-868653
ABSTRACT
Data on residual clinical damage after Coronavirus disease-2019 (COVID-19) are lacking. The aims of this study were to investigate whether COVID-19 leaves behind residual dysfunction, and identify patients who might benefit from post-discharge monitoring. All patients aged ≥18 years admitted to the Emergency Department (ED) for COVID-19, and evaluated at post-discharge follow-up between 7 April and 7 May, 2020, were enrolled. Primary outcome was need of follow-up, defined as the presence at follow-up of at least one among respiratory rate (RR) >20 breaths/min, uncontrolled blood pressure (BP) requiring therapeutic change, moderate to very severe dyspnoea, malnutrition, or new-onset cognitive impairment, according to validated scores. Post-traumatic stress disorder (PTSD) served as secondary outcome. 185 patients were included. Median [interquartile range] time from hospital discharge to follow-up was 23 [20-29] days. 109 (58.9%) patients needed follow-up. At follow-up evaluation, 58 (31.3%) patients were dyspnoeic, 41 (22.2%) tachypnoeic, 10 (5.4%) malnourished, 106 (57.3%) at risk for malnutrition. Forty (21.6%) patients had uncontrolled BP requiring therapeutic change, and 47 (25.4%) new-onset cognitive impairment. PTSD was observed in 41 (22.2%) patients. At regression tree analysis, the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) and body mass index (BMI) at ED presentation, and age emerged as independent predictors of the need of follow-up. Patients with PaO2/FiO2 <324 and BMI ≥33 Kg/m2 had the highest odds to require follow-up. Among hospitalised patients, age ≥63 years, or age <63 plus non-invasive ventilation or diabetes identified those with the highest probability to need follow-up. PTSD was independently predicted by female gender and hospitalisation, the latter being protective (odds ratio, OR, 4.03, 95% confidence interval, CI, 1.76 to 9.47, p 0.0011; OR 0.37, 95% CI 0.14 to 0.92, p 0.033, respectively). COVID-19 leaves behind physical and psychological dysfunctions. Follow-up programmes should be implemented for selected patients.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Stress Disorders, Post-Traumatic / Coronavirus Infections / Malnutrition / Dyspnea / Cognitive Dysfunction Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0239570

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Stress Disorders, Post-Traumatic / Coronavirus Infections / Malnutrition / Dyspnea / Cognitive Dysfunction Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0239570