Patient symptoms following discharge from hospital after COVID-19 pneumonia
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Introduction The recovery of patients after COVID-19 has been poorly described Related coronavirus infections (SARSCOV1 and MERS) have protracted recovery time-courses with significant respiratory morbidity,1 suggesting the same may be true for COVID-19 A service evaluation was therefore undertaken to evaluate the short-term effects of COVID-19 Methods Respiratory specialist doctors conducted structured telephone consultations of patients admitted between 17th March 2020 and 2nd May 2020 with a diagnosis of COVID- 19 pneumonia at a teaching hospital Using time from discharge patients were allocated into 3 groups: 3-4 weeks, 4-5 weeks and 5+ Patients were asked to recall acute COVID-19 symptoms, current symptoms, activity levels, and exercise capacity after discharge Exercise capacity was quantified by self-assessment of walking distance on flat (metres), stairs (flights) Patient reported outcome measures (MRC dyspnoea scale and WHO performance status) were also collated Results A total of 102 patients were screened, 70 were included in the study, with the rest being unreachable (n=32) Cough, dyspnoea, fever and lethargy were the most common symptoms at time of admission All these symptoms, except lethargy, improved following discharge (figure 1) Prevalence in the 5+ week cohort of other symptoms is as follows: dyspnoea 35 7%, cough 11 5%, fever 0%;however, 70% of patients had at least 1 symptom 5 weeks after discharge Self-reported exercise capacity and MRC dyspnoea score also improved after discharge Despite this 21 4% of patients had a persistent impairment in walking ability on the flat, 17 8% in stair-climbing with 28 5% persistent deficit in MRC dyspnoea score after 5 weeks In contrast 40% of patients had a deficit in WHO performance status and this was not affected by time after discharge In conclusion patients did improve following discharge from hospital for COVID-19 pneumonia, however many were left with residual symptoms and a functional deficit in short term (5 weeks) It remains to be seen whether this results in long term health problems
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