Prevalence and predictors of Post-Acute COVID-19 Syndrome (PACS) after hospital discharge: A cohort study with 4 months median follow-up
Post-acute COVID-19 syndrome (PACS) is an emerging healthcare burden. The risk factors associated with PACS remain largely unclear. The aim of this study was to evaluate the frequency of new or persistent symptoms in COVID-19 patients post hospital discharge and identify associated risk factors. Our...
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| Veröffentlicht in: | PloS one 2021-12, Vol.16 (12), p.e0260568-e0260568 |
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| creator | Tleyjeh, Imad M Saddik, Basema AlSwaidan, Nourah AlAnazi, Ahmed Ramakrishnan, Rakhee K Alhazmi, Deema Aloufi, Ahmad AlSumait, Fahad Berbari, Elie Halwani, Rabih |
| description | Post-acute COVID-19 syndrome (PACS) is an emerging healthcare burden. The risk factors associated with PACS remain largely unclear. The aim of this study was to evaluate the frequency of new or persistent symptoms in COVID-19 patients post hospital discharge and identify associated risk factors.
Our prospective cohort comprised of PCR-confirmed COVID-19 patients admitted to King Fahad Medical City, Riyadh, Saudi Arabia between May and July 2020. The patients were interviewed through phone calls by trained physicians from 6 weeks up to 6 months post hospital discharge. Multivariate Cox proportional hazards and logistic regression models were used to examine for predictors associated with persistence of symptoms and non-return to baseline health.
222 COVID-19 patients responded to follow-up phone interviews after a median of 122 days post discharge. The majority of patients were men (77%) with mean age of 52.47 (± 13.95) years. 56.3% of patients complained of persistent symptoms; 66 (29.7%) experiencing them for >21 days and 64 (28.8%) reporting not having returned to their baseline health. Furthermore, 39 patients (17.6%) reported visiting an emergency room post discharge for COVID-19-related symptoms while 16 (7.2%) had required re-hospitalization. Shortness of breath (40.1%), cough (27.5%) and fatigue (29.7%) were the most frequently reported symptoms at follow-up. After multivariable adjustments, female gender, pre-existing hypertension and length of hospital stay were associated with an increased risk of new or persistent symptoms. Age, pre-existing lung disease and emergency room visits increased the likelihood of not fully recovering from acute COVID-19. Patients who were treated with interferon β-1b based triple antiviral therapy during hospital stay were less likely to experience new or persistent symptoms and more likely to return to their baseline health.
COVID-19 survivors continued to suffer from dyspnea, cough and fatigue at 4 months post hospital discharge. Several risk factors could predict which patients are more likely to experience PACS and may benefit from individualized follow-up and rehabilitation programs. |
| doi_str_mv | 10.1371/journal.pone.0260568 |
| format | Article |
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Our prospective cohort comprised of PCR-confirmed COVID-19 patients admitted to King Fahad Medical City, Riyadh, Saudi Arabia between May and July 2020. The patients were interviewed through phone calls by trained physicians from 6 weeks up to 6 months post hospital discharge. Multivariate Cox proportional hazards and logistic regression models were used to examine for predictors associated with persistence of symptoms and non-return to baseline health.
222 COVID-19 patients responded to follow-up phone interviews after a median of 122 days post discharge. The majority of patients were men (77%) with mean age of 52.47 (± 13.95) years. 56.3% of patients complained of persistent symptoms; 66 (29.7%) experiencing them for >21 days and 64 (28.8%) reporting not having returned to their baseline health. Furthermore, 39 patients (17.6%) reported visiting an emergency room post discharge for COVID-19-related symptoms while 16 (7.2%) had required re-hospitalization. Shortness of breath (40.1%), cough (27.5%) and fatigue (29.7%) were the most frequently reported symptoms at follow-up. After multivariable adjustments, female gender, pre-existing hypertension and length of hospital stay were associated with an increased risk of new or persistent symptoms. Age, pre-existing lung disease and emergency room visits increased the likelihood of not fully recovering from acute COVID-19. Patients who were treated with interferon β-1b based triple antiviral therapy during hospital stay were less likely to experience new or persistent symptoms and more likely to return to their baseline health.
COVID-19 survivors continued to suffer from dyspnea, cough and fatigue at 4 months post hospital discharge. Several risk factors could predict which patients are more likely to experience PACS and may benefit from individualized follow-up and rehabilitation programs.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0260568</identifier><identifier>PMID: 34874962</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Aged ; Antiviral agents ; Antiviral drugs ; Biology and Life Sciences ; Cohort analysis ; Cohort Studies ; Coronaviruses ; Cough ; Cough - etiology ; COVID-19 ; COVID-19 - complications ; COVID-19 - epidemiology ; COVID-19 - pathology ; COVID-19 - psychology ; COVID-19 - virology ; Data collection ; Dyspnea ; Emergency medical care ; Emergency medical services ; Fatigue ; Fatigue - etiology ; Female ; Follow-Up Studies ; Health aspects ; Health care ; Health risks ; Hospital patients ; Hospitalization ; Hospitals ; Humans ; Hypertension ; Infections ; Infectious diseases ; Interferon ; Interviews ; Interviews as Topic ; Long COVID ; Lung diseases ; Male ; Medical research ; Medical schools ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Patient Discharge ; Patients ; Physical Sciences ; Physicians ; Post-Acute COVID-19 Syndrome ; Prevalence ; Regression analysis ; Regression models ; Rehabilitation ; Respiration ; Risk analysis ; Risk factors ; SARS-CoV-2 - isolation & purification ; Saudi Arabia ; Severe acute respiratory syndrome coronavirus 2 ; Signs and symptoms ; Surveys and Questionnaires ; Ventilators ; Young Adult</subject><ispartof>PloS one, 2021-12, Vol.16 (12), p.e0260568-e0260568</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Tleyjeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Tleyjeh et al 2021 Tleyjeh et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-27de6456bfbde7771729940eec53630801ea29b042bcbd45305a0621cf57d6343</citedby><cites>FETCH-LOGICAL-c593t-27de6456bfbde7771729940eec53630801ea29b042bcbd45305a0621cf57d6343</cites><orcidid>0000-0003-4634-4952 ; 0000-0002-9769-8147 ; 0000-0002-4682-5927 ; 0000-0002-2991-3802</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651136/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651136/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23853,27911,27912,53778,53780,79355,79356</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34874962$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Chen, Robert Jeenchen</contributor><creatorcontrib>Tleyjeh, Imad M</creatorcontrib><creatorcontrib>Saddik, Basema</creatorcontrib><creatorcontrib>AlSwaidan, Nourah</creatorcontrib><creatorcontrib>AlAnazi, Ahmed</creatorcontrib><creatorcontrib>Ramakrishnan, Rakhee K</creatorcontrib><creatorcontrib>Alhazmi, Deema</creatorcontrib><creatorcontrib>Aloufi, Ahmad</creatorcontrib><creatorcontrib>AlSumait, Fahad</creatorcontrib><creatorcontrib>Berbari, Elie</creatorcontrib><creatorcontrib>Halwani, Rabih</creatorcontrib><title>Prevalence and predictors of Post-Acute COVID-19 Syndrome (PACS) after hospital discharge: A cohort study with 4 months median follow-up</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Post-acute COVID-19 syndrome (PACS) is an emerging healthcare burden. The risk factors associated with PACS remain largely unclear. The aim of this study was to evaluate the frequency of new or persistent symptoms in COVID-19 patients post hospital discharge and identify associated risk factors.
Our prospective cohort comprised of PCR-confirmed COVID-19 patients admitted to King Fahad Medical City, Riyadh, Saudi Arabia between May and July 2020. The patients were interviewed through phone calls by trained physicians from 6 weeks up to 6 months post hospital discharge. Multivariate Cox proportional hazards and logistic regression models were used to examine for predictors associated with persistence of symptoms and non-return to baseline health.
222 COVID-19 patients responded to follow-up phone interviews after a median of 122 days post discharge. The majority of patients were men (77%) with mean age of 52.47 (± 13.95) years. 56.3% of patients complained of persistent symptoms; 66 (29.7%) experiencing them for >21 days and 64 (28.8%) reporting not having returned to their baseline health. Furthermore, 39 patients (17.6%) reported visiting an emergency room post discharge for COVID-19-related symptoms while 16 (7.2%) had required re-hospitalization. Shortness of breath (40.1%), cough (27.5%) and fatigue (29.7%) were the most frequently reported symptoms at follow-up. After multivariable adjustments, female gender, pre-existing hypertension and length of hospital stay were associated with an increased risk of new or persistent symptoms. Age, pre-existing lung disease and emergency room visits increased the likelihood of not fully recovering from acute COVID-19. Patients who were treated with interferon β-1b based triple antiviral therapy during hospital stay were less likely to experience new or persistent symptoms and more likely to return to their baseline health.
COVID-19 survivors continued to suffer from dyspnea, cough and fatigue at 4 months post hospital discharge. Several risk factors could predict which patients are more likely to experience PACS and may benefit from individualized follow-up and rehabilitation programs.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antiviral agents</subject><subject>Antiviral drugs</subject><subject>Biology and Life Sciences</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Coronaviruses</subject><subject>Cough</subject><subject>Cough - etiology</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - pathology</subject><subject>COVID-19 - psychology</subject><subject>COVID-19 - virology</subject><subject>Data collection</subject><subject>Dyspnea</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Fatigue</subject><subject>Fatigue - etiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health risks</subject><subject>Hospital patients</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Interferon</subject><subject>Interviews</subject><subject>Interviews as Topic</subject><subject>Long COVID</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical schools</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Patient Discharge</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Physicians</subject><subject>Post-Acute COVID-19 Syndrome</subject><subject>Prevalence</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Rehabilitation</subject><subject>Respiration</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>SARS-CoV-2 - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tleyjeh, Imad M</au><au>Saddik, Basema</au><au>AlSwaidan, Nourah</au><au>AlAnazi, Ahmed</au><au>Ramakrishnan, Rakhee K</au><au>Alhazmi, Deema</au><au>Aloufi, Ahmad</au><au>AlSumait, Fahad</au><au>Berbari, Elie</au><au>Halwani, Rabih</au><au>Chen, Robert Jeenchen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and predictors of Post-Acute COVID-19 Syndrome (PACS) after hospital discharge: A cohort study with 4 months median follow-up</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-12-07</date><risdate>2021</risdate><volume>16</volume><issue>12</issue><spage>e0260568</spage><epage>e0260568</epage><pages>e0260568-e0260568</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Post-acute COVID-19 syndrome (PACS) is an emerging healthcare burden. The risk factors associated with PACS remain largely unclear. The aim of this study was to evaluate the frequency of new or persistent symptoms in COVID-19 patients post hospital discharge and identify associated risk factors.
Our prospective cohort comprised of PCR-confirmed COVID-19 patients admitted to King Fahad Medical City, Riyadh, Saudi Arabia between May and July 2020. The patients were interviewed through phone calls by trained physicians from 6 weeks up to 6 months post hospital discharge. Multivariate Cox proportional hazards and logistic regression models were used to examine for predictors associated with persistence of symptoms and non-return to baseline health.
222 COVID-19 patients responded to follow-up phone interviews after a median of 122 days post discharge. The majority of patients were men (77%) with mean age of 52.47 (± 13.95) years. 56.3% of patients complained of persistent symptoms; 66 (29.7%) experiencing them for >21 days and 64 (28.8%) reporting not having returned to their baseline health. Furthermore, 39 patients (17.6%) reported visiting an emergency room post discharge for COVID-19-related symptoms while 16 (7.2%) had required re-hospitalization. Shortness of breath (40.1%), cough (27.5%) and fatigue (29.7%) were the most frequently reported symptoms at follow-up. After multivariable adjustments, female gender, pre-existing hypertension and length of hospital stay were associated with an increased risk of new or persistent symptoms. Age, pre-existing lung disease and emergency room visits increased the likelihood of not fully recovering from acute COVID-19. Patients who were treated with interferon β-1b based triple antiviral therapy during hospital stay were less likely to experience new or persistent symptoms and more likely to return to their baseline health.
COVID-19 survivors continued to suffer from dyspnea, cough and fatigue at 4 months post hospital discharge. Several risk factors could predict which patients are more likely to experience PACS and may benefit from individualized follow-up and rehabilitation programs.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34874962</pmid><doi>10.1371/journal.pone.0260568</doi><orcidid>https://orcid.org/0000-0003-4634-4952</orcidid><orcidid>https://orcid.org/0000-0002-9769-8147</orcidid><orcidid>https://orcid.org/0000-0002-4682-5927</orcidid><orcidid>https://orcid.org/0000-0002-2991-3802</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-12, Vol.16 (12), p.e0260568-e0260568 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2607595906 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Aged Antiviral agents Antiviral drugs Biology and Life Sciences Cohort analysis Cohort Studies Coronaviruses Cough Cough - etiology COVID-19 COVID-19 - complications COVID-19 - epidemiology COVID-19 - pathology COVID-19 - psychology COVID-19 - virology Data collection Dyspnea Emergency medical care Emergency medical services Fatigue Fatigue - etiology Female Follow-Up Studies Health aspects Health care Health risks Hospital patients Hospitalization Hospitals Humans Hypertension Infections Infectious diseases Interferon Interviews Interviews as Topic Long COVID Lung diseases Male Medical research Medical schools Medicine Medicine and Health Sciences Middle Aged Patient Discharge Patients Physical Sciences Physicians Post-Acute COVID-19 Syndrome Prevalence Regression analysis Regression models Rehabilitation Respiration Risk analysis Risk factors SARS-CoV-2 - isolation & purification Saudi Arabia Severe acute respiratory syndrome coronavirus 2 Signs and symptoms Surveys and Questionnaires Ventilators Young Adult |
| title | Prevalence and predictors of Post-Acute COVID-19 Syndrome (PACS) after hospital discharge: A cohort study with 4 months median follow-up |
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