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Journal Article Observational Study Epublish 5 citations

PubMed: 36694110 DOI: 10.1186/s12879-023-08006-4

A multidisciplinary approach to screen the post-COVID-19 conditions.

BMC Infect Dis 23(1):54

Authors: Nicola Squillace, Viola Cogliandro, Emanuela Rossi, Giuseppe Bellelli, Matteo Pozzi, Fabrizio Luppi, Maddalena Lettino, Maria Grazia Strepparava, Carlo Ferrarese, Ester Pollastri, Elena Ricci, Paolo Bonfanti

Affiliations

  • Infectious Disease Unit, Fondazione IRCCS San Gerardo dei Tintori, Via GB Pergolesi, 33, Monza, Italy.
  • Infectious Disease Unit, Fondazione IRCCS San Gerardo dei Tintori, Via GB Pergolesi, 33, Monza, Italy.
  • Bicocca Center of Bioinformatics, Biostatistics and Bioimaging, University of Milano-Bicocca, Monza, Italy.
  • Acute Geriatric Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
  • Anesthesia and Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Respiratory Disease Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Cardiology Division, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Clinical Psychology Unit, Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Neurology Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Fondazione ASIA, Buccinasco, Italy.

Abstract

BACKGROUND

Post-COronaVIrus Disease 2019 (COVID-19) conditions (PCC) include multiple symptoms afflicting different organs and systems. To evaluate the frequency and type of them, we described our multidisciplinary approach with preliminary results of the first enrolled patients.

METHODS

We included patients aged ≥ 18 years with hospital admission for confirmed SARS-CoV-2 infection. Symptoms were grouped in five macro groups hereafter referred to as "Symptoms Category" (SC): respiratory SC (dyspnoea or cough), neurological SC (peripheral neuropathies, headache, impaired mobility, behavioural disorders), psychological SC (sleep disorders, mood disorders), muscular SC (arthromyalgia, asthenia), other SC (fever, alopecia, diarrhoea, weight loss, smell and taste alterations, sexual dysfunctions). SC were evaluated at discharge and at follow-up. Association between patients' characteristics and presence of SC at follow up was estimated by a logistic multivariable regression model.

RESULTS

From June 2020 to July 2021, we followed up 361 patients: 128 (35.5%) who were previously admitted to Intensive Care Unit (ICU) and 233 patients to ordinary department. The median length of hospital stay was 20 days (Inter-Quartile-Range 13-32). Most patients (317/361, 87.8%) were still symptomatic at discharge, with one third referring three or more SC. At follow up, 67.3% (243/361) of patients still complained at least one SC. Moreover, 159 patients (44%) developed at least one new involved SC during follow up: 116 (72.9%) one SC, 39 (24.5%) two SC, 4 (2.5%) three or more SC. At follow up visit 130 of 361 (36%) were still with SC developed during follow up. At multivariable analysis presence of any SC at follow-up was associated with male gender (Odds Ratio [OR] 3.23, Confidence Interval [CI] 95% 1.46-7.15), ICU admission (OR 2.78, CI 95% 1.29-5.96) and presence of SC at discharge (OR 14.39, CI 95% 6.41-32.32).

CONCLUSIONS

In our sample of patients with severe COVID-19, we found that PCC are highly variable and fluctuating over time; in particular, in about 50% of our patients new SC appear during follow up. Moreover, presence of PCC also in patients without SC at discharge and the variability of symptoms underlining the advisability of our multidisciplinary approach.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov Identifier: NCT04424992, registered on 28 February 2020 https://www.

CLINICALTRIALS

gov/ct2/results?recrs=ab&cond=&term=NCT04424992&cntry=&state=&city=&dist   The current version of protocol is version 1.0 enrolling since June 2020. The enrollment is still ongoing.

MeSH

Mood Disorders, Signs And Symptoms, Covid-19, Intensive Care Units, Communicable Diseases

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