Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study

Xiong, Qiutang; Xu, Ming; Li, Jiao; Liu, Yinghui; Zhang, Jixiang; Xu, Yu; Dong, Weiguo

OBJECTIVES: To describe the prevalence, nature, and risk factors for the main clinical sequelae in COVID-19 survivors who have been discharged from the hospital for more than 3 months. METHODS: This longitudinal study was based on a telephone follow-up survey of COVID-19 patients hospitalized and discharged from Renmin Hospital of Wuhan University, Wuhan, China before March 1, 2020. Demographic and clinical characteristics and self-reported clinical sequelae of the survivors were described and analysed. A cohort of volunteers who were free of COVID-19 and lived in the urban area of Wuhan during the outbreak were also selected as the comparison group. RESULTS: Among 538 survivors (293[54.5%] female), the median age was 52.0 years (IQR 41.0–62.0), and the median time from discharge from hospital to first follow-up was 97.0 days (IQR 95.0–102.0). Clinical sequelae were common, including general symptoms (n=267, 49.6%), respiratory symptoms (n=210, 39%), cardiovascular-related symptoms (n=70, 13%), psychosocial symptoms (n=122, 22.7%) and alopecia (n=154, 28.6%). We found that physical decline/fatigue (P<0.01), post-activity polypnea (P=0.04) and alopecia (P<0.01) were more common in females than in males. Dyspnoea during hospitalization was associated with subsequent physical decline/fatigue, post-activity polypnea and resting heart rate increases, but not specifically with alopecia. A history of asthma during hospitalization was associated with subsequent post-activity polypnea sequela. A history of pulse ≥90 beats per min during hospitalization was associated with resting heart rate increase in convalescence. The duration of viral shedding after COVID-19 onset and hospital length of stay were longer in survivors with physical decline/fatigue or post-activity polypnea than in those without. CONCLUSION: Clinical sequelae during early COVID-19 convalescence were common, and some of these sequelae might be related to gender, age and clinical characteristics during hospitalization.