Long‐term clinical, nutritional, and functional outcomes of COVID‐19 patients after hospital discharge

Abstract

AbstractBackgroundLong‐term nutritional and functional status after hospitalization due to COVID‐19 has been poorly described. We show the physical and nutritional stata and the symptoms compatible with Long‐COVID in patients who survived after an episode of hospitalization due to COVID‐19 and the associated factors.MethodsSingle‐center prospective observational study. Clinical, nutritional, and physical function data were assessed in 345 subjects over 18 years of age hospitalized in an university hospital for a diagnosis of COVID‐19 in 2020 at three different times of follow‐up: 6 (n = 118), 9 (n = 115), and 15 months (n = 112) after discharge. All survivors discharged during each of those periods were called consecutively at the times of follow‐up in order to collect data about their nutritional and functional stata, and long‐COVID symptoms.ResultsThe mean age of the 345 subjects included in the present study was 62.8 years (SD 15.8), and 180 (52.2%) were men. The mean number of comorbidities was 2.6 (SD 2.1). After a mean follow‐up time of 10.2 ± 3.2 months, mean Barthel score showed a decrease of 2.00 (SD 0.12) points, that showed to be consistent disregarding the time after discharge (6 months: 1.71 ± 4.8; 9 months: 2.17 ± 5.97; 15 months: 2.20 ± 5.25). The risk factors associated with worsening in the Barthel index score were basal Barthel index [BI < 95; odds ratio (OR): 3.34, 95% confidence interval (CI): 1.26–8.85], age (OR: 1.03, CI: 1.00–1.06, per year), having comorbidities (≥3 pathologies) (OR: 1.98, CI: 1.00–3.90), and female sex (OR: 2.68, CI: 1.47–4.90). Self‐reported Long‐COVID symptoms were frequent, mainly those related to functioning: fatigue/tiredness (39.4%), decreased mobility (16.2%), and subjective loss of muscle mass/strength (15.9%) plus mental complaints (depression/anxiety; 20.6%). Decreased mobility (OR 7.82, CI: 3.69–16.55), cognitive impairment (OR 6.76, CI: 2.22–20.58) and a score in SARC‐F ≥ 2 (OR: 3.89; CI: 2.03–7.49) at follow‐up were associated to the worsening in BI. BMI showed a modest, non‐significant decrease at 6 months (−0.3 ± 1.7 kg/m2), that was fully recovered in the longest follow‐up period (+0.4 ± 2.1).ConclusionsAdmission for COVID‐19 produces a significant functional loose, mainly in those who are older, female, and with a poor basal functional status and comorbidities. This impairment does not recover spontaneously and is a main component of the long‐term COVID‐19 symptoms.