Predictors of postacute coronavirus disease 2019 syndrome an experience of 669 patients

Context
Severe acute respiratory syndrome coronavirus 2, a novel coronavirus first identified in Wuhan, China in late 2019, caused a global outbreak of viral pneumonia known as coronavirus disease 2019 (COVID-19). As the number of survivors increases, understanding the long-term consequences, referred to as postacute COVID-19 syndrome (PACS), becomes increasingly important.


Aim
To study the incidence, risk factors and predictors of PACS.


Settings and design
A descriptive analytical prospective longitudinal work.


Patients and methods
This work involved 669 participants confirmed COVID-19 infection by PCR then allocated into two groups (group I patient with PACS and group II patient without PACS), conducted at Mansoura University Emergency Hospitals at Respiratory Triage Zone over a period of 1 year from September 2021 to 2022. Four weeks later follow-up was done at Mansoura University post-COVID outpatient clinic or isolation center in Mansoura University Hospitals.


Results
There were 169 (25.3%) cases with PACS and 500 (74.7%) without PACS. There was significant increase in age, male sex, and ratio of patients with comorbidities in group I contrasted to group II. A highly significant rise in smokers, ex-smokers, and ratio of patients with diabetes mellitus existed in group I contrasted to group II. A highly significant decrease in number of vaccinated patients existed in group I contrasted to group II. The most frequent symptom was dyspnea in 143 (84.6%) cases then fatigue and (receiver operating characteristic) curve shows that the best cutoff point of hemoglobin (gm/dl), serum creatinine (mg/dl), C-reactive protein, D-dimer (mg/dl), lactate dehydrogenaze (U/L) and serum ferritin to detect group I was less than or equal to 11.9, greater than 1, greater than 24, greater than 0.3, greater than 256, and greater than 260, respectively.


Conclusion
“Older age, male sex, smoking history, and comorbidities—particularly diabetes—were associated with higher risk of PACS. Laboratory markers such as C-reactive protein, lactate dehydrogenaze, D-dimer, and ferritin may serve as practical tools for identifying at-risk patients.”