Post-COVID syndrome: Clinical pattern and impact on health related quality of life

Background
COVID-19 management has changed from just dealing with a novel respiratory viral illness to unraveling the mystery of a systemic disease. This study aimed to assess clinical pattern for post-COVID survivors and impact on quality of life.


Methods
115 Patients suffering from COVID-19 affection were recruited in this study. The assessment included clinical history with special attention to symptoms attributable to post-COVID manifestations. Evaluation for presence of insomnia, anxiety and depression were done using insomnia severity index (ISI), Hamilton’s anxiety (HAM-A) and depression rating scales (HAM-D), respectively. Laboratory investigations included complete blood count (CBC), kidney function test, liver function test, C-reactive protein (CRP), and inflammatory markers including ESR, CRP and Ferritin level. EQ-5D-5L and EQ visual analogue scale (EQ-VAS) were used to assess participants’ overall health status and quality of life.


Results
COVID-19 patients suffered from cough (76%), fever (72.9%), fatigue (72.9%), dyspnea (69.8%) and muscle/joint pain (66.1%) as the most distressing symptoms during period of acute infection. Regarding post-COVID syndrome (PCS); Dyspnea (32.2%), fatigue (26.1%), muscle/joint pain (22.6%), loss of taste (16.5%) and loss of smell (15.7%) were the most prevalent at 3 month evaluation. 46.9% patients developed manifestations attributable to post-COVID syndrome. Fever, cough, loss of smell and taste, fatigue, anxiety and insomnia persisted significantly for longer periods among severe cases (Group 2). EQ-5D-5L domains were significantly impaired among severe COVID patients. Significant positive correlation noticed between age and increased duration of dyspnea, muscle/joint pains and depression. Also, CT chest severity scores showed significant correlation with dyspnea, fatigue, muscle/joint pains (P=0.023, 0.012 and <0.001; respectively).


Conclusion
High prevalence of Post-COVID syndrome is a challenge to health care resources. PCS directly impacts mobility, self-care, usual activities, pain perception and anxiety and therefore is associated with lower quality of life among post-COVID patients.