Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
- -
- ≥18 years old
- -
- infection with SARS-CoV-2 (PCR-tested) at least six weeks prior to the initial consultation
- -
- sufficient German language skills.
2.2. Study Population
2.3. Questionnaires
2.4. Tests and Examinations
2.5. Laboratory Parameters
2.6. Statistics
3. Results
3.1. Characteristics of Patients with PCS
3.2. Baseline Characteristics and Follow-Up
3.3. Symptoms and Scores over Time
3.4. Laboratory Tests
4. Discussion
4.1. Comparison with Other Studies
4.2. Strength and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Female (n = 124) | Male (n = 34) | Total (n = 158) | p-Value | |
---|---|---|---|---|
Age mean (SD) | 48.5 (13.8) | 47.1 (16.1) | 48.2 (14.3) | 0.669 |
BMI mean (SD) | 28.7 (6.2) | 29.5 (5.6) | 28.9 (6.1) | 0.669 |
Corona Waves n (%) | 0.479 | |||
1st Wave (incl. summer 2020) | 6 (4.8) | 1 (2.9) | 7 (4.4) | |
2nd Wave | 54 (43.6) | 18 (52.9) | 72 (45.6) | |
3rd Wave (VOC Alpha) incl. summer 2021 | 45 (36.3) | 8 (23.5) | 53 (33.5) | |
4th/5th Wave (VOC Delta/Omicron) | 19 (15.3) | 7 (20.6) | 27 (16.5) | |
Preexisting comorbidities n (%) | ||||
Diabetes | 10 (8.0) | 3 (8.8) | 13 (8.2) | 0.877 |
Hypertension | 32 (25.6) | 13 (38.2) | 45 (28.5) | 0.155 |
Respiratory diseases * | 13 (10.4) | 3 (8.2) | 16 (10.1) | 0.776 |
Depression | 16 (12.9) | 3 (8.8) | 19 (12.0) | 0.517 |
Rheumatoid arthritis | 31 (25.0) | 11 (32.3) | 42 (26.6) | 0.390 |
Headache | 11 (8.9) | 1 (2.9) | 12 (7.6) | 0.248 |
Smoking status n (%) | ||||
Smoker | 14 (13.1) | 6 (20.7) | 20 (14.7) | 0.529 |
Former smoker | 16 (15.0) | 3 (10.3) | 19 (14.0) |
T0 | T1 | T2 | |
---|---|---|---|
6-MWT distance | 459.8 (6.9) | 481.4 (7.4) *** | 499.8 (8.3) *** |
HR before 6-MWT | 80.9 (1.1) | 75.2 (1.2) *** | 73.5 (1.4) *** |
HR after 6-MWT | 101.7 (1.6) | 97.3 (1.8) * | 94.5 (2.1) ** |
HR change 6-MWT | 21.1 (1.5) | 22.2 (1.7) | 20.8 (2.1) |
BR before 6-MWT | 16.7 (0.3) | 16.1 (0.4) | 15.3 (0.4) *** |
BR after 6-MWT | 22.9 (0.6) | 21.2 (0.7) * | 20.4 (0.8) ** |
BR change 6-MWT | 6.2 (0.5) | 5.3 (0.6) | 5.0 (0.7) |
Borg Scale 6-MWT (6–20) (a) pinteraction = 0.044 | |||
wk05/20–wk08/21 | 13.3 (0.3) | 12.6 (0.3) ** | 12.8 (0.3) |
wk09/21–wk30/21 | 12.8 (0.3) | 12.2 (0.3) * | 11.4 (0.4) *** |
wk31/21–wk52/22 | 14.7 (0.5) | 13.9 (0.6) | 11.9 (0.9) ** |
O2 saturation at rest | 98.1 (0.2) | 97.4 (0.2) ** | 97.8 (0.2) |
O2 saturation after 6-MWT | 97.8 (0.1) | 97.6 (0.1) * | 97.7 (0.1) |
BPsys | 129.4 (1.4) | 127.9 (1.5) | 123.0 (1.7) *** |
BPdia | 82.0 (1.2) | 77.3 (1.4) ** | 80.1 (1.5) |
FAS | 34.3 (0.7) | 30.9 (0.8) *** | 28.2 (0.9) *** |
GAD-7 | 9.1 (0.4) | 7.8 (0.4) *** | 5.8 (0.5) *** |
PHQ-9 | 11.4 (0.4) | 9.4 (0.5) *** | 7.9 (0.5) *** |
MoCA | 25.5 (0.2) | 26.2 (0.3) * | 26.7 (0.4) ** |
CAT | 17.1 (0.5) | 14.3 (0.6) *** | 12.1 (0.6) *** |
MCRS | 14.4 (1.0) | 12.6 (1.1) | 7.5 (1.4) *** |
VR-12 (MCS) | 23.5 (1.1) | 28.2 (1.2) *** | 33.5 (1.3) *** |
VR-12 (PCS) (a) pinteraction = 0.007 | |||
wk05/20–wk08/21 | 33.4 (1.4) | 37.8 (1.5) *** | 39.4 (1.5) *** |
wk09/21–wk30/21 | 33.2 (1.8) | 38.6 (1.8) *** | 42.2 (1.9) *** |
wk31/21–wk52/22 | 29.3 (2.6) | 30.8 (2.9) | 44.9 (3.5) *** |
ITQ-1 | 10.7 (0.7) | 9.3 (0.8) * | 7.4 (0.9) *** |
T0 | T1 | T2 | |
---|---|---|---|
FAS | |||
No fatigue | 15 (9.6) | 19 (16.7) | 21 (27.3) |
Fatigue | 64 (40.8) | 53 (46.5) | 39 (50.7) |
Severe Fatigue | 78 (49.7) | 42 (36.8) | 17 (16.4) |
GAD-7 | |||
0 minimal | 36 (23.7) | 32 (28.8) | 42 (53.9) |
1 mild | 47 (30.9) | 44 (39.6) | 21 (26.9) |
2 moderate | 40 (26.3) | 21 (18.9) | 13 (16.7) |
3 severe | 29 (19.1) | 14 (12.6) | 2 (2.6) |
PHQ-9 | |||
0 minimal | 17 (11.1) | 22 (20.0) | 26 (33.3) |
1 mild | 48 (31.4) | 43 (39.1) | 28 (35.9) |
2 moderate | 43 (28.1) | 25 (22.7) | 17 (21.8) |
3 moderately severe | 33 (21.6) | 13 (11.8) | 7 (9.0) |
4 severe | 12 (7.8) | 7 (6.4) | 0 (0.0) |
MoCA | |||
<26 | 61 (38.9) | 35 (31.0) | 18 (25.0) |
>26 | 96 (61.1) | 78 (69.0) | 54 (75.0) |
PCFS | |||
Grade 0 | 0 (0.0) | 5 (4.4) | 10 (13.0) |
Grade 1 | 11 (7.0) | 18 (15.8) | 16 (20.8) |
Grade 2 | 90 (57.0) | 65 (57.0) | 44 (57.1) |
Grade 3 | 55 (34.8) | 24 (21.0) | 7 (9.1) |
Grade 4 | 2 (1.3) | 2 (1.8) | 0 (0.0) |
Laboratory Findings | Limits of Normal | T0 Mean (SD) | ||
---|---|---|---|---|
Hemoglobin | 7.4–10.0/8.6–11.2 | mmol/L | 8.88 (0.80) | mmol/L |
Erythrocytes | 4.2–5.4/4.6–6.2 | Tpt/L | 4.82 (0.41) | Tpt/L |
Leukocytes | 4.3–10.0 | Gpt/L | 6.96 1.98) | Gpt/L |
Lymphocytes abs. | −5.0 | Gpt/L | 1.98 (0.61) | Gpt/L |
Thrombocytes | 140–440 | Gpt/L | 271.14 (61.82) | Gpt/L |
CRP | <5 | mg/L | 7.23 (4.14) | mg/L |
Vit. D | >30 | µg/L | 29.57 (16.77) | µg/L |
ALAT | <0.77 | µkatal/L | 0.54 (0.28) | µkatal/L |
ASAT | <0.59 | µkatal/L | 0.36 (0.28) | µkatal/L |
Bilirubin | <17 | µmol/L | 8.41 (4.08) | µmol/L |
Calcium | 2.12–2.52 | mmol/L | 2.38 (0.09) | mmol/L |
Cholesterol | <6.0 | mmol/L | 5.72 (1.27) | mmol/L |
Creatine kinase | <7.9 | µkatal/L | 1.75 (0.75) | µkatal/L |
GGT | <0.96 | µkatal/L | 0.52 (1.62) | µkatal/L |
Glucose | 3.9–6.4 | mmol/L | 5.66 (0.78) | mmol/L |
HDL Cholesterol | >1.03 | mmol/L | 1.56 (0.46) | mmol/L |
Uric acid | 155–428 | µmol/L | 289.00 (93.47) | µmol/L |
Urea | 2.5–6.4 | mmol/L | 5.01 (1.18) | mmol/L |
Potassium | 3.5–4.6 | mmol/L | 4.02 (0.30) | mmol/L |
Creatinine | 42–97 | µmol/L | 67.52 (14.88) | µmol/L |
LDL Cholesterol | <3.34 | mmol/L | 3.52 (1.10) | mmol/L |
Lipase | 1.59–6.36 | µkatal/L | 2.36 (0.85) | µkatal/L |
Sodium | 135–145 | mmol/L | 142.42 (2.48) | mmol/L |
NT-proBNP | <125 | pg/mL | 80.41 (129.82) | pg/mL |
Phosphate | 0.6–1.6 | mmol/L | 0.99 (0.16) | mmol/L |
Triglycerides | <1.9 | mmol/L | 1.56 (0.97) | mmol/L |
Hs cTroponin I | <59 | ng/L | 7.46 (5.81) | ng/L |
TSH | 0.49–3.29 | mU/L | 1.51 (0.76) | mU/L |
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Steinmetz, A.; Gross, S.; Lehnert, K.; Lücker, P.; Friedrich, N.; Nauck, M.; Bahlmann, S.; Fielitz, J.; Dörr, M. Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up. J. Clin. Med. 2023, 12, 3966. https://doi.org/10.3390/jcm12123966
Steinmetz A, Gross S, Lehnert K, Lücker P, Friedrich N, Nauck M, Bahlmann S, Fielitz J, Dörr M. Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up. Journal of Clinical Medicine. 2023; 12(12):3966. https://doi.org/10.3390/jcm12123966
Chicago/Turabian StyleSteinmetz, Anke, Stefan Gross, Kristin Lehnert, Petra Lücker, Nele Friedrich, Matthias Nauck, Susanne Bahlmann, Jens Fielitz, and Marcus Dörr. 2023. "Longitudinal Clinical Features of Post-COVID-19 Patients—Symptoms, Fatigue and Physical Function at 3- and 6-Month Follow-Up" Journal of Clinical Medicine 12, no. 12: 3966. https://doi.org/10.3390/jcm12123966