Persistent Health Problems beyond Pulmonary Recovery up to 6 Months after Hospitalization for SARS-CoV-2; A Longitudinal Study of Respiratory, Physical and Psychological Outcomes.

Hellemons, M E; Huijts, S; Bek, L; Berentschot, J; Nakshbandi, G; Schurink, C A M; Vlake, J; van Genderen, M E; van Bommel, J; Gommers, D; Odink, A; Ciet, P; Shamier, M C; GeurtsvanKessel, C; Baart, S J; Ribbers, G M; van den Berg-Emons, H G; Heijenbrok-Kal, M H; Aerts, J G J V

RATIONALE Data on longitudinal recovery after hospitalization for SARS-CoV-2 remain currently scarce, just as outcomes beyond 3 months follow-up. OBJECTIVE The aim of the study was to evaluate the sequelae up to 6 months after hospitalization for SARS-CoV-2 infection, considering 1) the recovery of pulmonary function and radiological abnormalities, physical and mental health status, and health-related quality of life (HR-QoL); and 2) the predictors of the most clinically relevant sequelae. METHODS Patients were evaluated at 6 weeks, 3 and 6 months after hospitalization with pulmonary function testing, radiological evaluation, and online questionnaires on physical and mental health status and HR-QoL. Outcomes were analyzed with repeated measurements analyses. RESULTS Ninety-two patients were included; mean age 58.2±12.3 years, and 58 (63.0%) males. The estimated percentage of patients with impaired FVC improved from 25% at 6 weeks to 11% at 6 months; for impaired diffusion capacity this percentage improved from 63% to 46%.. Radiologically ground glass decreased, but fibrosis persisted. The majority of patients (89.1%) still reported >1 symptom 6 months after discharge. Fatigue decreased significantly over time (p=0.006). Nonetheless, fatigue remained present in 51% of the patients at 6 months. HR-QoL (nearly) normalized in most domains at 6 months, except for physical role functioning, with persistent fatigue and length of hospitalization as most important predictors. CONCLUSIONS During the first 6 months after hospitalization for SARS-CoV-2 most patients demonstrated continuing recovery across all health domains, but persistent sequelae were frequent. Fatigue was the most frequent residual and persisting symptom up to 6 months after hospitalization, importantly impacting HR-QoL.