Descriptive analysis of long COVID sequela identified in a multidisciplinary clinic serving hospitalised and non-hospitalised patients

Johnsen, Stine; Sattler, Stefan M.; Miskowiak, Kamilla Woznica; Kunalan, Keerthana; Victor, Alan; Pedersen, Lars; Andreassen, Helle Frost; Jørgensen, Barbara Jolanta; Heebøll, Hanne; Andersen, Michael Brun; Marner, Lisbeth; Hædersdal, Carsten; Hansen, Henrik; Ditlev, Sisse Bolm; Porsbjerg, Celeste; Lapperre, Thérèse S.

BACKGROUND: There is emerging data of long-term effects of COVID-19 comprising a diversity of symptoms. The aim of this study was to systematically describe and measure pulmonary and extra- pulmonary post COVID-19 complications in relation to acute COVID-19 severity. METHODS: Patients attending a standard of care 3-months post-hospitalisation follow-up visit, and those referred by their general practitioner because of persistent post-COVID-19 symptoms were included. Patients underwent symptomatic, quality of life, pulmonary (lung function and HRCT), cardiac (high resolution ECG), physical (1-MSTST, handgrip strength, CPET) and cognitive evaluations. RESULTS: All 34 hospitalised and 22 out of 23 non-hospitalised patients had≥1 complaint or abnormal finding at follow-up. 67% of patients were symptomatic (MRC ≥2 or CAT ≥10), with no difference between hospitalised versus non-hospitalised patients. Pulmonary function (FEV1 or DLCO) <80% of predicted) was impaired in 68% of patients. DLCO was significantly lower in those hospitalised compared to non-hospitalised (70.1±18.0 versus 80.2±11.2% predicted, p=0.02). 53% had an abnormal HRCT (predominantly groundglass opacities) with higher composite CT-scores in hospitalised versus non-hospitalised patients (2.3 [0.1, 4.8] and 0.0 [0.0, 0.3], p<0.001). 1-MSTST was below the 25th percentile in almost half of patients, but no signs of cardiac dysfunction were found. Cognitive impairments were present in 59–66% of hospitalised and 31–44% of non-hospitalised patients (p=0.08). CONCLUSION: Three months after COVID-19 infection, patients were still symptomatic and demonstrated objective respiratory, functional, radiological and cognitive abnormalities, which were more prominent in hospitalised patients. Our study underlines the importance of multidimensional management strategies in these patients.