A Follow-up Study Of Discharged Patients With COVID-19 At One Year

Objective:The Long-term outcomes and differences in post-acute patients with COVID-19 compared with healthy population are unclear.This study aimed to assess the clinical symptoms,physical capacity and health related quality of life（HRQo L）between post-acute patients with COVID-19 and healthy population at one year after clinical recovery.Method:This observational,healthy controlled,follow-up study recruited post-acute patients with COVID-19,discharged between January 30th,2020 to April 8th,2020,and healthy volunteers matched demographic characteristics.Demographic data,clinical symptoms,neuropsychological test score,6-minute walk test（6-MWT）,and health-related quality of life score（SF-36）were collected.Acute phase data of COVID-19 subjects were collected from electronic medical record systems.Mann-Whitney U test was used for continuous variables and proportions for categorical variables were compared using theχ2 test or the Fisher exact test.Pearson correlations was evaluated between long outcomes and acute-phase inflammatory markers in the COVID-19 group.Partial correlation analysis was conducted to control the confounding effects of age,sex,BMI,and education level.Result:23 post-acute patients with COVID-19 were recruited and their persistent physical symptoms were analyzed.Three patients refused to complete the 6-MWT were excluded.Finally,20 patients（COVID-19group）and 20 healthy participants（HC group）entered the comparative analysis.The common persistent symptoms reported were cough（43.5%）,dyspnea（39.1%）and fatigue（26.1%）at a median follow-up time of 353（IQR 332.3-357.8）days.Patients with severe type or aged over 60 years reported a higher proportion in dyspnea.The two groups were well matched at baseline.The Athens Insomnia Scale Score（AIS）（8.0 VS 4.5,P=0.037）and the proportion of sleep disorder（65%VS 25%,P=0.011）in the COVID-19 group were significantly higher,while anxiety,depression,and scores of cognitive function were similar to the HC group.There was no significant reduction in 6-minute walk distance（6-MWD）of COVID-19 group.The finger pulse oxygen level（SpO₂）after 6-MWT（94.2±3.1 VS 96.8±1.4,P=0.001）was lower in COVID-19 group and the decrease of SpO₂（-1.5±2.2 VS 0.6±1.5,P=0.001）was more obvious.Only Physical Functioning,Role-Physical and Social Functioning dimensions of SF-36 scale decreased significantly in COVID-19 group compared with HC group.Subgroup analysis showed that there were significant differences in AIS score,logical memory score change value（LM）,6-MWD and SpO2 change value,correlated with C-reactive protein level at the acute phase,between normal and severe patients.After adjusting for age,gender,BMI and education level,the above correlations were still significant with the partial correlation coefficients were r_AIS=0.603（P=0.017）,r_LM=-0.792（P<0.001）,r_6-MWD=-0.538（P=0.039）and r_SpO2=-0.576（P=0.025）,respectively.Conclusion:First,post-acute patients with COVID-19 at one year after discharge presented persistent symptoms,with most common symptoms were sleep disorder,cough,dyspnea and fatigue.Second,there was a certain degree of impairment in physical capacity and HRQo L among discharged patients compared with healthy population.