Residual clinical damage after COVID-19: A retrospective and prospective observational cohort study

  1. De Lorenzo, Rebecca
  2. Conte, Caterina
  3. Lanzani, Chiara
  4. Benedetti, Francesco
  5. Roveri, Luisa
  6. Mazza, Mario G.
  7. Brioni, Elena
  8. Giacalone, Giacomo
  9. Canti, Valentina
  10. Sofia, Valentina
  11. D’Amico, Marta
  12. Di Napoli, Davide
  13. Ambrosio, Alberto
  14. Scarpellini, Paolo
  15. Castagna, Antonella
  16. Landoni, Giovanni
  17. ZANGRILLO, Alberto ORCID logo
  18. Bosi, Emanuele
  19. Tresoldi, Moreno
  20. Ciceri, Fabio
  21. Rovere Querini, Patrizia ORCID logo

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1000 Titel
  • Residual clinical damage after COVID-19: A retrospective and prospective observational cohort study
1000 Autor/in
  1. De Lorenzo, Rebecca |
  2. Conte, Caterina |
  3. Lanzani, Chiara |
  4. Benedetti, Francesco |
  5. Roveri, Luisa |
  6. Mazza, Mario G. |
  7. Brioni, Elena |
  8. Giacalone, Giacomo |
  9. Canti, Valentina |
  10. Sofia, Valentina |
  11. D’Amico, Marta |
  12. Di Napoli, Davide |
  13. Ambrosio, Alberto |
  14. Scarpellini, Paolo |
  15. Castagna, Antonella |
  16. Landoni, Giovanni |
  17. ZANGRILLO, Alberto |
  18. Bosi, Emanuele |
  19. Tresoldi, Moreno |
  20. Ciceri, Fabio |
  21. Rovere Querini, Patrizia |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-10-14
1000 Erschienen in
1000 Quellenangabe
  • 15(10):e0239570
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1371/journal.pone.0239570 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556454/ |
1000 Ergänzendes Material
  • https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239570#sec014 |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Data on residual clinical damage after Coronavirus disease-2019 (COVID-19) are lacking. The aims of this study were to investigate whether COVID-19 leaves behind residual dysfunction, and identify patients who might benefit from post-discharge monitoring. All patients aged ≥18 years admitted to the Emergency Department (ED) for COVID-19, and evaluated at post-discharge follow-up between 7 April and 7 May, 2020, were enrolled. Primary outcome was need of follow-up, defined as the presence at follow-up of at least one among: respiratory rate (RR) >20 breaths/min, uncontrolled blood pressure (BP) requiring therapeutic change, moderate to very severe dyspnoea, malnutrition, or new-onset cognitive impairment, according to validated scores. Post-traumatic stress disorder (PTSD) served as secondary outcome. 185 patients were included. Median [interquartile range] time from hospital discharge to follow-up was 23 [20–29] days. 109 (58.9%) patients needed follow-up. At follow-up evaluation, 58 (31.3%) patients were dyspnoeic, 41 (22.2%) tachypnoeic, 10 (5.4%) malnourished, 106 (57.3%) at risk for malnutrition. Forty (21.6%) patients had uncontrolled BP requiring therapeutic change, and 47 (25.4%) new-onset cognitive impairment. PTSD was observed in 41 (22.2%) patients. At regression tree analysis, the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2) and body mass index (BMI) at ED presentation, and age emerged as independent predictors of the need of follow-up. Patients with PaO2/FiO2 <324 and BMI ≥33 Kg/m2 had the highest odds to require follow-up. Among hospitalised patients, age ≥63 years, or age <63 plus non-invasive ventilation or diabetes identified those with the highest probability to need follow-up. PTSD was independently predicted by female gender and hospitalisation, the latter being protective (odds ratio, OR, 4.03, 95% confidence interval, CI, 1.76 to 9.47, p 0.0011; OR 0.37, 95% CI 0.14 to 0.92, p 0.033, respectively). COVID-19 leaves behind physical and psychological dysfunctions. Follow-up programmes should be implemented for selected patients.
1000 Sacherschließung
lokal Dyspnea
gnd 1206347392 COVID-19
lokal Diabetes mellitus
lokal Malnutrition
lokal Critical care and emergency medicine
lokal Oxygen
lokal Post-traumatic stress disorder
lokal Cognitive impairment
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