JMIR Publications

ABSTRACT

Background:

Hospitalized SARS-CoV-2-infected patients should recover within a few weeks. However, even those with mild versions can have signs and symptoms lasting four weeks or longer. These post-COVID conditions (PCC) comprise various new, returning, or ongoing conditions and symptoms that can last months, years, or cause disability. There have been no studies of PCC using self-reporting by discharged SARS-CoV-2-infected patients to complement clinical and biomarker studies.

Objective:

Investigate self-reported, persistent PCC among SARS-CoV-2-infected patients discharged during the pandemic’s second and third waves.

Methods:

Following a literature review, an ad hoc paper questionnaire on PCC was designed, pretested, and posted to all eligible inpatients discharged between October 2020 and April 2021. At four months after discharge, we collected data on PCC and scores for the Multidimensional Fatigue Inventory (MFI), the Patient Health Questionnaire-4 (PHQ-4), a Brief Memory Screening Scale (Q3PC), and a post-traumatic stress disorder scale (PCL-5). Descriptive, inferential, and multivariate linear regression statistics were computed to assess PCC symptomatology, associations, and differences regarding sociodemographic characteristics and hospital length of stay (LOS). We computed whether our variables of interest could significantly predict patients’ MFI scores.

Results:

Of the 1993 valid questionnaires returned, 245 were from discharged SARS-CoV-2-infected patients. That sub-sample’s median age was 71. Only 28.2% of SARS-CoV-2 infected respondents were symptom-free after four months. Significant differences were found between men’s and women’s numbers of PCC symptoms (P = .003) and LOS (P > .001): men had more symptoms and longer LOS. No significant differences were found between age groups (P = .500) and hospitalization units (P = .092). Significant differences were found between self-reported PHQ-4 scores during hospitalization and four months after (P < .001), with higher scores among hospitalized patients. Three-quarters (76.4%) of the respondents affected by COVID-19 reported memory loss and concentration disorders (Q3PC). No significant differences regarding the median MFI score of 56 were found in the sociodemographic variables. Significant differences were found between the median PCL-5 score and LOS, with higher scores among respondents with longer stays (P = .009). Multivariate linear regression allowed us to calculate that the combination of PHQ-4, Q3PC, and PCL-5 scores, adjusted for age, sex, and LOS, did not significantly predict MFI scores (R2 = 0.093 (F (3/197) = 1.500; P = .216 adjusted R2 = 0.061.).

Conclusions:

The majority of SARS-CoV-2-infected inpatients presented with PCCs at four months after discharge, with complex clinical pictures. Only one-third of them were symptom-free during that time. MFI scores were not directly related to self-reported depression, anxiety, or post-traumatic scores adjusted for age, sex, or LOS. More research is needed to explore PCC and fatigue based on the self-reported health experiences of discharged SARS-CoV-2-infected inpatients.