From 1, March to 31, July 2020, 309 patients were discharged from hospitalization due to Covid-19. 66 patients participated in our research (21.36%). Demographic characteristics and comorbidities are shown in Table 1. Age on admission was 58.5 years (49.8–68.3), 56.1% of patients being female. More than a third of the patients were obese (36.4%) with a high mean BMI of 29.1. After obesity, hypertension was the most frequent comorbidity (31.8%), followed by diabetes (24.2%), ischemic heart disease (13.6%), and chronic lung disease (12.1%).
Hospitalization characteristics, length of follow-up, and PROMs are also reported in Table 1. The median length of stay for patients hospitalized for COVID-19 was 7 days (IQR 4–10). Most patients had a mild (40.9%) or moderate disease (30.3%) not requiring oxygen supplementation in 75.7% of cases. Still, 28.8% of the patients had severe disease with almost a quarter requiring either oxygen supplementation via a nasal prone, mask (19.7%), HFNC, or noninvasive ventilation (4.5%).
PROMs were obtained after a median follow-up of 9-month (IQR 6–9). In the results from the Rand-36 questionnaire emotional role, physical role, social and physical function had the highest scores (100, 87.5, 87.5, and 80 respectively), while emotional well-being, pain, general health, and vitality had lower scores (74, 67.5, 60, and 57.5 respectively) and heath change had the lowest score with a median of 25.
There was no significant association between age or gender and the different HRQoL scores. Overall, patients with comorbidities had lower scores on many of the different categories, some significantly so. In this regard, especially notable is the pain score in which significant differences were found in patients with or without ischemic heart disease (22.5 vs 77.5 p = 0.01), diabetes (33.7 vs 80 p < 0.01), lung disease (22.5 vs 72.5 p = 0.04), and obesity (33.7 vs 85 p = 0.02). Considering hospitalization characteristics, no association was found between length of stay and the different scores, although all the different scores were lower by disease severity and need for any oxygen supplementation. However, these differences were not statistically significant. Finally, the length of follow-up was weakly but significantly correlated to physical function and emotional well-being (rs=0.255, p = 0.04 and rs=0.283, p = 0.02 respectively). In-group association between patient demographics, patient comorbidities, hospitalization characteristics, and questionnaire scores are shown in Table S1 and S2.
Many patients complained about the sequela of COVID-19 infection; 57% of patients still suffered from at least one symptom and 34% suffered from 2 symptoms or more. Most frequently reported was fatigue (50%), followed by myalgia (23.7%), weakness and shortness of breath (18.4% each) (Fig. 1). Eighty-nine percent of patients with severe disease suffered at least one symptom compared to 65% and 44% of patients with moderate and mild disease severity, respectively.
We matched for age and/or gender a subgroup of 42 COVID-19 patients to patients hospitalized with pneumonia due to other pathogens. A comparison of the groups is shown in Table 2. Non-COVID-19 patients were more frequently current or past smokers (50% vs 11.9%, p < 0.01) and suffered more often from chronic lung disease (38.1% vs 9.5%, p = 0.01). COVID-19 patients had longer hospitalizations than patients in the non-COVID-19 group (8 vs 4 days, p < 0.01), and were also followed up after a shorter period (7.5 vs 9-month, p < 0.01). Comparing the different RAND-36 scores, non-COVID-19 patients had lower scores in most categories with a trend towards significance in physical function and role (55 vs 80, p = 0.07 and 25 vs 75, p = 0.07 respectively). On the other hand, health change was significantly lower in the COVID-19 group (25 vs 50, p < 0.01).