Post COVID-19 persistent symptoms and functional status in COVID-19 survivors: a multi-center study

Abstract

Post COVID symptoms are a series of chronic symptoms that patients may experience after resolution of acute COVID-19. Different post-COVID-19 condition phenotypes might exist, although exact causes, management, and outcomes are not known. To assess the functional status among post-COVID-19 survivors and identify the associated socio-demographic, clinical, and laboratory risk factors of the poor functional status among those cases and to identify the most common persistent symptoms among post-COVID-19 survivors after discharge. This was a cross-sectional study conducted on 150 recovered cases who had been infected with COVID-19 as confirmed by swab during hospitalization and being interviewed regarding functional status 6 months post-hospital discharge. Cases were divided into two groups: the decreased functional status group (n = 74) and the non-decreased functional status group (n = 76). The present study indicated statistically significant differences between the studied groups; receiving the influenza vaccine was significantly associated with keeping the pre-COVID functional status (p = 0.02). The reduced functional status group had a significantly more severe disease course, prolonged hospital as well as ICU stay (p < 0.001), and worse CT findings than the normal functional status group (p = 0.004). Long-term symptoms such as headache, mood changes, insomnia, hearing problems, dry eyes, breathlessness, and chest tightness were significantly more prevalent among those who reported limitations in their functional status (p < 0.001). There were significantly higher CRP, serum ferritin, and D-dimer in the reduced functional status group. The present study highlights that most COVID-19 recovered cases have different degrees of functional limitations ranging from null to severe based on the PCFS scale. These limitations were affected by periodic influenza vaccination, ICU admission, and length of hospital stay. Some laboratory parameters were associated with reduced functionality: CRP, D-dimer, and serum ferritin. Psychological/neurological symptoms and breathlessness were significantly associated with reduced PCFS. This calls for public health action and necessitates widespread health education of post-COVID-19 health consequences.