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31-01-2023 | Long-COVID Syndrome | IM - ORIGINAL

Longitudinal medical subspecialty follow-up of critically and non-critically ill hospitalized COVID-19 survivors up to 24 months after discharge

Authors: Benjamin Musheyev, Montek S. Boparai, Reona Kimura, Rebeca Janowicz, Stacey Pamlanye, Wei Hou, Tim Q. Duong

Published in: Internal and Emergency Medicine | Issue 2/2023

Abstract

Medical specialty usage of COVID-19 survivors after hospital discharge is poorly understood. This study investigated medical specialty usage at 1–12 and 13–24 months post-hospital discharge in critically ill and non-critically ill COVID-19 survivors. This retrospective study followed ICU (N = 89) and non-ICU (N = 205) COVID-19 survivors who returned for follow-up within the Stony Brook Health System post-hospital discharge. Follow-up data including survival, hospital readmission, ongoing symptoms, medical specialty care use, and ICU status were examined 1–12 and 13–24 months after COVID-19 discharge. “New” (not previously seen) medical specialty usage was also identified. Essentially all (98%) patients survived. Hospital readmission was 34%, but functional status scores at discharge were not associated with hospital readmission. Many patients reported ongoing [neuromuscular (50%) respiratory (39%), chronic fatigue (35%), cardiovascular (30%), gastrointestinal (28%), neurocognitive (22%), genitourinary (22%), and mood-related (13%)] symptoms at least once 1–24 months after discharge. Common specialty follow-ups included cardiology (25%), vascular medicine (17%), urology (17%), neurology (16%), and pulmonology (14%), with some associated with pre-existing comorbidities and with COVID-19. Common new specialty visits were vascular medicine (11%), pulmonology (11%), and neurology (9%). ICU patients had more symptoms and follow-ups compared to the non-ICU patients. This study reported high incidence of persistent symptoms and medical specialty care needs in hospitalized COVID-19 survivors 1–24 months post-discharge. Some specialty care needs were COVID-19 related or exacerbated by COVID-19 disease while others were associated with pre-existing medical conditions. Longer follow-up studies of COVID-19 survivor medical care needs are necessary.

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Groff D, Sun A, Ssentongo AE, Ba DM, Parsons N, Poudel GR, Lekoubou A, Oh JS, Ericson JE, Ssentongo P, Chinchilli VM (2021) Short-term and long-term rates of postacute sequelae of SARS-CoV-2 infection: a systematic review. JAMA Netw Open 4:e2128568. https://doi.org/10.1001/jamanetworkopen.2021.28568CrossRefPubMedPubMedCentral

Augustin M, Schommers P, Stecher M, Dewald F, Gieselmann L, Gruell H, Horn C, Vanshylla K, Cristanziano VD, Osebold L, Roventa M, Riaz T, Tschernoster N, Altmueller J, Rose L, Salomon S, Priesner V, Luers JC, Albus C, Rosenkranz S, Gathof B, Fatkenheuer G, Hallek M, Klein F, Suarez I, Lehmann C (2021) Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Eur 6:100122. https://doi.org/10.1016/j.lanepe.2021.100122CrossRefPubMedPubMedCentral

Kamal M, Abo Omirah M, Hussein A, Saeed H (2021) Assessment and characterisation of post-COVID-19 manifestations. Int J Clin Pract 75:e13746. https://doi.org/10.1111/ijcp.13746CrossRefPubMed

Munblit D, Bobkova P, Spiridonova E, Shikhaleva A, Gamirova A, Blyuss O, Nekliudov N, Bugaeva P, Andreeva M, DunnGalvin A, Comberiati P, Apfelbacher C, Genuneit J, Avdeev S, Kapustina V, Guekht A, Fomin V, Svistunov AA, Timashev P, Subbot VS, Royuk VV, Drake TM, Hanson SW, Merson L, Carson G, Horby P, Sigfrid L, Scott JT, Semple MG, Warner JO, Vos T, Olliaro P, Glybochko P, Butnaru D, Sechenov Stop CRT (2021) Incidence and risk factors for persistent symptoms in adults previously hospitalized for COVID-19. Clin Exp Allergy 51:1107–1120. https://doi.org/10.1111/cea.13997CrossRefPubMedPubMedCentral

Willi S, Luthold R, Hunt A, Hanggi NV, Sejdiu D, Scaff C, Bender N, Staub K, Schlagenhauf P (2021) COVID-19 sequelae in adults aged less than 50 years: a systematic review. Travel Med Infect Dis 40:101995. https://doi.org/10.1016/j.tmaid.2021.101995CrossRefPubMedPubMedCentral

Huang L, Li X, Gu X, Zhang H, Ren L, Guo L, Liu M, Wang Y, Cui D, Wang Y, Zhang X, Shang L, Zhong J, Wang X, Wang J, Cao B (2022) Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. Lancet Respir Med. https://doi.org/10.1016/s2213-2600(22)00126-6CrossRefPubMedPubMedCentral

Zeng N, Zhao YM, Yan W, Li C, Lu QD, Liu L, Ni SY, Mei H, Yuan K, Shi L, Li P, Fan TT, Yuan JL, Vitiello MV, Kosten T, Kondratiuk AL, Sun HQ, Tang XD, Liu MY, Lalvani A, Shi J, Bao YP, Lu L (2022) A systematic review and meta-analysis of long term physical and mental sequelae of COVID-19 pandemic: call for research priority and action. Mol Psychiatry. https://doi.org/10.1038/s41380-022-01614-7CrossRefPubMedPubMedCentral

Sanchez-Ramirez DC, Normand K, Zhaoyun Y, Torres-Castro R (2021) Long-term impact of COVID-19: a systematic review of the literature and meta-analysis. Biomedicines. https://doi.org/10.3390/biomedicines9080900CrossRefPubMedPubMedCentral

Tran VT, Porcher R, Pane I, Ravaud P (2022) Course of post COVID-19 disease symptoms over time in the ComPaRe long COVID prospective e-cohort. Nat Commun 13:1812. https://doi.org/10.1038/s41467-022-29513-zCrossRefPubMedPubMedCentral

10.

Whitaker M, Elliott J, Chadeau-Hyam M, Riley S, Darzi A, Cooke G, Ward H, Elliott P (2022) Persistent COVID-19 symptoms in a community study of 606,434 people in England. Nat Commun 13:1957. https://doi.org/10.1038/s41467-022-29521-zCrossRefPubMedPubMedCentral

11.

Townsend L, Dyer AH, Jones K, Dunne J, Mooney A, Gaffney F, O’Connor L, Leavy D, O’Brien K, Dowds J, Sugrue JA, Hopkins D, Martin-Loeches I, Ni Cheallaigh C, Nadarajan P, McLaughlin AM, Bourke NM, Bergin C, O’Farrelly C, Bannan C, Conlon N (2020) Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLoS ONE 15:e0240784. https://doi.org/10.1371/journal.pone.0240784CrossRefPubMedPubMedCentral

12.

Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Miao X, Li Y, Hu B (2020) Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 77:683–690. https://doi.org/10.1001/jamaneurol.2020.1127CrossRefPubMed

13.

Carfi A, Bernabei R, Landi F, Gemelli Against C-P-ACSG (2020) Persistent symptoms in patients after acute COVID-19. JAMA 324:603–605. https://doi.org/10.1001/jama.2020.12603CrossRefPubMedPubMedCentral

14.

Garrigues E, Janvier P, Kherabi Y, Le Bot A, Hamon A, Gouze H, Doucet L, Berkani S, Oliosi E, Mallart E, Corre F, Zarrouk V, Moyer JD, Galy A, Honsel V, Fantin B, Nguyen Y (2020) Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect 81:e4–e6. https://doi.org/10.1016/j.jinf.2020.08.029CrossRefPubMedPubMedCentral

15.

Moghimi N, Di Napoli M, Biller J, Siegler JE, Shekhar R, McCullough LD, Harkins MS, Hong E, Alaouieh DA, Mansueto G, Divani AA (2021) The neurological manifestations of post-acute sequelae of SARS-CoV-2 infection. Curr Neurol Neurosci Rep 21:44. https://doi.org/10.1007/s11910-021-01130-1CrossRefPubMedPubMedCentral

16.

Iosifescu AL, Hoogenboom WS, Buczek AJ, Fleysher R, Duong TQ (2022) New-onset and persistent neurological and psychiatric sequelae of COVID-19 compared to influenza: A retrospective cohort study in a large New York City healthcare network. Int J Methods Psychiatr Res. https://doi.org/10.1002/mpr.1914CrossRefPubMedPubMedCentral

17.

Musheyev B, Borg L, Janowicz R, Matarlo M, Boyle H, Singh G, Ende V, Babatsikos I, Hou W, Duong TQ (2021) Functional status of mechanically ventilated COVID-19 survivors at ICU and hospital discharge. J Intensive Care 9:31. https://doi.org/10.1186/s40560-021-00542-yCrossRefPubMedPubMedCentral

18.

Musheyev B, Janowicz R, Borg L, Matarlo M, Boyle H, Hou W, Duong TQ (2021) Characterizing non-critically ill COVID-19 survivors with and without in-hospital rehabilitation. Sci Rep 11:21039. https://doi.org/10.1038/s41598-021-00246-1CrossRefPubMedPubMedCentral

19.

Prevention CfDCa, Long COVID or Post-COVID Conditions, Accessed March 1st 2022.

20.

Chen A, Zhao Z, Hou W, Singer AJ, Li H, Duong TQ (2021) Time-to-death longitudinal characterization of clinical variables and longitudinal prediction of mortality in COVID-19 patients: a two-center study. Front Med (Lausanne) 8:661940. https://doi.org/10.3389/fmed.2021.661940CrossRefPubMed

21.

Ende VJ, Singh G, Babatsikos I, Hou W, Li H, Thode HC, Singer AJ, Duong TQ, Richman PS (2021) Survival of COVID-19 patients with respiratory failure is related to temporal changes in gas exchange and mechanical ventilation. J Intensive Care Med 36:1209–1216. https://doi.org/10.1177/08850666211033836CrossRefPubMedPubMedCentral

22.

Hou W, Zhao Z, Chen A, Li H, Duong TQ (2021) Machining learning predicts the need for escalated care and mortality in COVID-19 patients from clinical variables. Int J Med Sci 18:1739–1745. https://doi.org/10.7150/ijms.51235CrossRefPubMedPubMedCentral

23.

Lam KW, Chow KW, Vo J, Hou W, Li H, Richman PS, Mallipattu SK, Skopicki HA, Singer AJ, Duong TQ (2020) Continued in-hospital ACE inhibitor and ARB Use in hypertensive COVID-19 patients is associated with positive clinical outcomes. J Infect Dis 222:1256–1264. https://doi.org/10.1093/infdis/jiaa447CrossRefPubMed

24.

Li X, Ge P, Zhu J, Li H, Graham J, Singer A, Richman PS, Duong TQ (2020) Deep learning prediction of likelihood of ICU admission and mortality in COVID-19 patients using clinical variables. PeerJ 8:e10337. https://doi.org/10.7717/peerj.10337CrossRefPubMedPubMedCentral

25.

Lu JQ, Musheyev B, Peng Q, Duong TQ (2021) Neural network analysis of clinical variables predicts escalated care in COVID-19 patients: a retrospective study. PeerJ 9:e11205. https://doi.org/10.7717/peerj.11205CrossRefPubMedPubMedCentral

26.

Holu JY, Hou W, Duong TQ (2022) Longitudinal prediction of hospital-acquired acute kidney injury in COVID-19: a two-center study. Infection 50:109–119. https://doi.org/10.1007/s15010-021-01646-1CrossRef

27.

Shen B, Hoshmand-Kochi M, Abbasi A, Glass S, Jiang Z, Singer AJ, Thode HC, Li H, Hou W, Duong TQ (2021) Initial chest radiograph scores inform COVID-19 status, intensive care unit admission and need for mechanical ventilation. Clin Radiol 76:473.e471-473.e477. https://doi.org/10.1016/j.crad.2021.02.005CrossRef

28.

Zhao Z, Chen A, Hou W, Graham JM, Li H, Richman PS, Thode HC, Singer AJ, Duong TQ (2020) Prediction model and risk scores of ICU admission and mortality in COVID-19. PLoS ONE 15:e0236618. https://doi.org/10.1371/journal.pone.0236618CrossRefPubMedPubMedCentral

29.

Ramzi ZS (2022) Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis. Am J Emerg Med 51:267–279. https://doi.org/10.1016/j.ajem.2021.10.059CrossRefPubMed

30.

Ayoubkhani D, Khunti K, Nafilyan V, Maddox T, Humberstone B, Diamond I, Banerjee A (2021) Post-COVID syndrome in individuals admitted to hospital with COVID-19: retrospective cohort study. BMJ. https://doi.org/10.1136/bmj.n693CrossRefPubMed

31.

Michelen M, Manoharan L, Elkheir N, Cheng V, Dagens A, Hastie C, O’Hara M, Suett J, Dahmash D, Bugaeva P, Rigby I, Munblit D, Harriss E, Burls A, Foote C, Scott J, Carson G, Olliaro P, Sigfrid L, Stavropoulou C (2021) Characterising long COVID: a living systematic review. BMJ Glob Health. https://doi.org/10.1136/bmjgh-2021-005427CrossRefPubMed

32.

Romero-Duarte A, Rivera-Izquierdo M, Guerrero-Fernandez de Alba I, Perez-Contreras M, Fernandez-Martinez NF, Ruiz-Montero R, Serrano-Ortiz A, Gonzalez-Serna RO, Salcedo-Leal I, Jimenez-Mejias E, Cardenas-Cruz A (2021) Sequelae, persistent symptomatology and outcomes after COVID-19 hospitalization: the ANCOHVID multicentre 6-month follow-up study. BMC Med 19:129. https://doi.org/10.1186/s12916-021-02003-7CrossRefPubMedPubMedCentral

33.

Darcis G, Bouquegneau A, Maes N, Thys M, Henket M, Labye F, Rousseau AF, Canivet P, Desir C, Calmes D, Schils R, De Worm S, Leonard P, Meunier P, Moutschen M, Louis R, Guiot J (2021) Long-term clinical follow-up of patients suffering from moderate-to-severe COVID-19 infection: a monocentric prospective observational cohort study. Int J Infect Dis 109:209–216. https://doi.org/10.1016/j.ijid.2021.07.016CrossRefPubMedPubMedCentral

34.

Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re’em Y, Redfield S, Austin JP, Akrami A (2021) Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 38:101019. https://doi.org/10.1016/j.eclinm.2021.101019CrossRefPubMedPubMedCentral

35.

Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, Kang L, Guo L, Liu M, Zhou X, Luo J, Huang Z, Tu S, Zhao Y, Chen L, Xu D, Li Y, Li C, Peng L, Li Y, Xie W, Cui D, Shang L, Fan G, Xu J, Wang G, Wang Y, Zhong J, Wang C, Wang J, Zhang D, Cao B (2021) 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet 397:220–232. https://doi.org/10.1016/s0140-6736(20)32656-8CrossRef

36.

Petersen MS, Kristiansen MF, Hanusson KD, Danielsen ME, B AS, Gaini S, Strom M, Weihe P, (2021) Long COVID in the Faroe Islands: A Longitudinal Study Among Nonhospitalized Patients. Clin Infect Dis 73:e4058–e4063. https://doi.org/10.1093/cid/ciaa1792CrossRefPubMed

37.

Logue JK, Franko NM, McCulloch DJ, McDonald D, Magedson A, Wolf CR, Chu HY (2021) Sequelae in adults at 6 months after COVID-19 infection. JAMA Netw Open 4:e210830. https://doi.org/10.1001/jamanetworkopen.2021.0830CrossRefPubMedPubMedCentral

38.

Arnold DT, Hamilton FW, Milne A, Morley AJ, Viner J, Attwood M, Noel A, Gunning S, Hatrick J, Hamilton S, Elvers KT, Hyams C, Bibby A, Moran E, Adamali HI, Dodd JW, Maskell NA, Barratt SL (2021) Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax 76:399–401. https://doi.org/10.1136/thoraxjnl-2020-215818CrossRefPubMed

39.

Boscolo-Rizzo P, Guida F, Polesel J, Marcuzzo AV, Capriotti V, D’Alessandro A, Zanelli E, Marzolino R, Lazzarin C, Antonucci P, Sacchet E, Tofanelli M, Borsetto D, Gardenal N, Pengo M, Tirelli G (2021) Sequelae in adults at 12 months after mild-to-moderate coronavirus disease 2019 (COVID-19). Int Forum Allergy Rhinol 11:1685–1688. https://doi.org/10.1002/alr.22832CrossRefPubMedPubMedCentral

40.

Bellan M, Baricich A, Patrucco F, Zeppegno P, Gramaglia C, Balbo PE, Carriero A, Amico CS, Avanzi GC, Barini M, Battaglia M, Bor S, Cantaluppi V, Cappellano G, Ceruti F, Chiocchetti A, Clivati E, Giordano M, Cuneo D, Gambaro E, Gattoni E, Loro A, Manfredi M, Morosini U, Murano F, Paracchini E, Patti G, Pinato DJ, Raineri D, Rolla R, Sainaghi PP, Tricca S, Pirisi M (2021) Long-term sequelae are highly prevalent one year after hospitalization for severe COVID-19. Sci Rep 11:22666. https://doi.org/10.1038/s41598-021-01215-4CrossRefPubMedPubMedCentral

41.

Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, Ma K, Xu D, Yu H, Wang H, Wang T, Guo W, Chen J, Ding C, Zhang X, Huang J, Han M, Li S, Luo X, Zhao J, Ning Q (2020) Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. https://doi.org/10.1136/bmj.m1091CrossRefPubMedPubMedCentral

42.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z (2020) Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 323:1061–1069. https://doi.org/10.1001/jama.2020.1585CrossRefPubMedPubMedCentral

43.

Lu JQ, Lu JY, Wang W, Liu Y, Buczek A, Fleysher R, Hoogenboom WS, Zhu W, Hou W, Rodriguez CJ, Duong TQ (2022) Clinical predictors of acute cardiac injury and normalization of troponin after hospital discharge from COVID-19. EBioMedicine. https://doi.org/10.1016/j.ebiom.2022.103821CrossRefPubMedPubMedCentral

44.

Lu JY, Anand H, Frager SZ, Hou W, Duong TQ (2021) Longitudinal progression of clinical variables associated with graded liver injury in COVID-19 patients. Hepatol Int 15:1018–1026. https://doi.org/10.1007/s12072-021-10228-0CrossRefPubMed

45.

Lu JY, Babatsikos I, Fisher MC, Hou W, Duong TQ (2021) Longitudinal clinical profiles of hospital vs. community-acquired acute kidney injury in COVID-19. Front Med (Lausanne) 8:647023. https://doi.org/10.3389/fmed.2021.647023CrossRefPubMed

46.

Lu JY, Buczek A, Fleysher R, Hoogenboom WS, Hou W, Rodriguez CJ, Fisher MC, Duong TQ (2021) Outcomes of Hospitalized Patients With COVID-19 With Acute Kidney Injury and Acute Cardiac Injury. Front Cardiovasc Med 8:798897. https://doi.org/10.3389/fcvm.2021.798897CrossRefPubMed

47.

Hong J, Ahn SY, Lee YJ, Lee JH, Han JW, Kim KH, Yhim HY, Nam SH, Kim HJ, Song J, Kim SH, Bang SM, Kim JS, Mun YC, Bae SH, Kim HK, Jang S, Park R, Choi HS, Kim I, Oh D, Korean Society of Hematology T, Hemostasis Working P (2021) Updated recommendations for the treatment of venous thromboembolism. Blood Res 56:6–16. https://doi.org/10.5045/br.2021.2020083CrossRefPubMedPubMedCentral

48.

Rawal G, Yadav S, Kumar R (2017) Post-intensive care syndrome: an overview. J Transl Int Med 5:90–92. https://doi.org/10.1515/jtim-2016-0016CrossRefPubMedPubMedCentral

49.

Tipping CJ, Bailey MJ, Bellomo R, Berney S, Buhr H, Denehy L, Harrold M, Holland A, Higgins AM, Iwashyna TJ, Needham D, Presneill J, Saxena M, Skinner EH, Webb S, Young P, Zanni J, Hodgson CL (2016) The ICU mobility scale has construct and predictive validity and is responsive. a multicenter observational study. Ann Am Thorac Soc 13:887–893. https://doi.org/10.1513/AnnalsATS.201510-717OCCrossRefPubMed

50.

Torres OH, Francia E, Longobardi V, Gich I, Benito S, Ruiz D (2006) Short- and long-term outcomes of older patients in intermediate care units. Intensive Care Med 32:1052–1059. https://doi.org/10.1007/s00134-006-0170-1CrossRefPubMed

Title: Longitudinal medical subspecialty follow-up of critically and non-critically ill hospitalized COVID-19 survivors up to 24 months after discharge
Authors: Benjamin Musheyev
Montek S. Boparai
Reona Kimura
Rebeca Janowicz
Stacey Pamlanye
Wei Hou
Tim Q. Duong
Publication date: 31-01-2023
Publisher: Springer International Publishing
Keywords: Long-COVID Syndrome
Cardiology
SARS-CoV-2
COVID-19
Neurology
Post-COVID Syndrome
Urology
Published in: Internal and Emergency Medicine / Issue 2/2023
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-023-03195-x

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