Non-hospitalized patients with acute COVID-19 suffer long-term symptoms

RATIONALE: Little is known regarding the long-term impact of acute COVID-19 in patients who did not require hospitalization with the acute infection. METHODS: Between June-November 2020, we reviewed patients in our dedicated COVID-19 “long haulers” clinic for those suffering persistent symptoms following recovery from COVID-19 infection. We prospectively collected the following data: pulmonary function test (Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC);6 minute walk test (6MWT);modified Medical Research Council (mMRC) dyspnea score;and health related quality of life (HRQL) using the Post-COVID-19 Functional Scale (PCFS) and EQ5D-5L questionnaires. All data is presented as mean±standard deviation.RESULTS: 17 patients [3 (17.6%) male] aged 49.2(11.7) years were assessed 105.1(41.4) days from molecular diagnosis of acute COVID-19. Four (23.5%) patients had a pre-morbid diagnosis of asthma. None were current smokers;6 (35.3%) were ex-smokers with a 4.2(4.5) pack year history. 17 (100%) reported at least one respiratory symptom (cough, wheeze, or dyspnea);9 (52.9%) described muscular pain or fatigue;8 (47%) reported chest pain;5 (29.4) reported neurocognitive symptoms (new or worsened headache, word finding difficulties or memory impairment) and 5 (29.4) also described fatigue. Despite an impaired mMRC score 1.9(1.6) and desaturation during the 6-minute walk test, spirometry was normal (Table 1). Patients reported an impaired health related quality of life with an EQ5D-5L Visual analogue score of 67.9(21.2);the mean normal for Albertans in the same matched age group 45-64 years is 76.3(17.9). The PCFS score remained elevated over 3 months' from confirmation of the acute infection 1.94(1.1).CONCLUSIONS: Irrespective of the severity of acute COVID-19 infection, patients may experience chronic persistent symptoms and impaired HRQL necessitating long-term follow up. r> TABLE 1. Baseline Characteristics at first clinic visit 105.1(41.4) days following confirmed acute COVID-19 infection. All data presented as mean±standard deviation. [FEV1= Forced Expiratory Volume in 1 second;FVC= Forced Vital Capacity;6MWT= 6-minute walk test;mMRC = modified Medical Research Council;EQ5D-5L VAS= EQ5D-5L Visual Analogue Scale.].