Clinical Question

Are adult survivors of COVID-19 still experiencing significant symptoms four months or more after hospital discharge?

Bottom Line

This study found that more than one-half of the adults (51%) who had been hospitalized for COVID-19 reported a significant amount of persistent symptoms four months after discharge. (Level of Evidence = 1b)

Synopsis

The investigators identified a cohort of adult patients, 18 years or older, who had been admitted to a hospital in France for COVID-19 from March 1, 2020, to May 29, 2020. Inclusion criteria were survival at four months after hospital discharge and a diagnosis of SARS-CoV-2 infection by polymerase chain reaction or clinical features associated with typical findings on computed tomography (CT) of the lung. Of the 834 eligible patients, 478 (57%) consented to respond by telephone to a questionnaire about their general condition and respiratory, cognitive, and neurologic symptoms. All patients who had been admitted to the intensive care unit (ICU) and those with continued symptoms were invited for an in-person evaluation. All patients seen in person received high-resolution CT of the lungs and psychometric testing, including an interview with a neuropsychologist. All those admitted to the ICU underwent transthoracic echocardiography. More than one-half (51%) of the patients reported at least one symptom that did not exist before their COVID-19 infection, including fatigue (31.1%), memory difficulties (17.5%), dyspnea (16.3%), and persistent paresthesia (12.1%). Psychometric testing and evaluation confirmed cognitive impairment in 38.4% of patients. Persistent abnormalities on CT and echocardiography were also commonly noted, especially among patients who required admission to the ICU.

Study design: Cohort (prospective)

Funding source: Government

Setting: Inpatient (any location) with outpatient follow-up

Reference: Writing Committee for the COMEBAC Study Group, Morin L, Savale L, Pham T, et al. Four-month clinical status of a cohort of patients after hospitalization for COVID-19. JAMA. 2021;325(15):1525–1534.