COVID-19: long-haulers experience pulmonary, mental, and cognitive declines for at least 3 months

  • van den Borst B & al.
  • Clin Infect Dis
  • 21 nov. 2020

  • de Liz Scherer
  • Clinical Essentials
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • Substantial numbers of patients recovering from COVID-19 will continue to experience residual pulmonary parenchymal abnormalities.
  • About a third may experience mental status and cognitive function decline.
  • Patients (predominantly female) who had "mild disease" experience inexplicable ongoing challenges to physical functioning, fatigue, and declines in QoL.

Why this matters

  • These patients may need extended (>3 months) follow-up for mental and cognitive declines to mitigate possible posttraumatic stress syndrome.
  • Multidisciplinary collaboration strategies are essential to address residual abnormalities.

Key results

  • 124 patients; mean age, 59 years.
  • COVID-19 severity: 20 critical, 26 severe, 51 moderate, 27 mild.
  • Across COVID-19 severity grades, 99% of patients had reduced ground glass opacification on repeat CT. 
    • 42% had lung diffusion capacity below lower limit of normal.
    • 91% had residual pulmonary parenchymal abnormalities at discharge.
  • 93% with mild disease had normal chest X-rays.
  • Proportion of patients with lingering limitations:
    • 22%, 6-minute walking distance
    • 16%, desaturation ≥4% upon 6-minute walking test.
    • 36%, mental/cognitive decline.
    • 10%, Hospital Anxiety and Depression Scale (HADS)-anxiety >10.
    • 12%, HADS-depression >10.
    • 15%, scores
  • Health status: fatigue (69%), functional impairments in daily life (64%), general QoL (72%).

Study design

  • Prospective observational study assessing long-term health consequences in Norwegian patients discharged following COVID-19 hospitalization.
  • Funding: None.

Limitations

  • Observational.
  • Survival, selection biases.
  • Limited generalizability.