Post-acute COVID-19 syndrome negatively impacts physical function, cognitive function, health-related quality of life and participation.

2021 
Objective This report describes persistent symptoms associated with post-acute COVID-19 syndrome (PACS), and the impact of these symptoms on physical function, cognitive function, health-related quality of life and participation. Design Cross-sectional observational study design. Patients attending Mount Sinai's PACS Clinic completed surveys containing patient-reported outcomes. Results A total of 156 patients completed the survey, at a median (range) time of 351 (82 to 457) days post COVID-19 infection. All patients were pre-vaccination. The most common persistent symptoms reported were fatigue (n = 128, 82%), brain fog (n = 105, 67%) and headache (n = 94, 60%). The most common triggers of symptom exacerbation were physical exertion (n = 134, 86%), stress (n = 107, 69%) and dehydration (n = 77, 49%). Increased levels of fatigue (Fatigue Severity Scale) and dyspnea (Medical Research Council) were reported, alongside reductions in levels of regularly completed physical activity. Ninety-eight (63%) patients scored for at least mild cognitive impairment (Neuro-Qol), and the domain of the EQ-5D-5 L most impacted was Self-care, Anxiety/Depression and Usual Activities. Conclusion Persistent symptoms associated with PACS appear to impact physical and cognitive function, health-related quality of life and participation in society. More research is needed to further clarify the relationship between COVID-19 infection and PACS symptoms, the underlying mechanisms, and treatment options.
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