P168\u2005Patient symptoms following discharge from hospital after COVID-19 Pneumonia

Abstract

Introduction The recovery of patients after COVID-19 has been poorly described. Related coronavirus infections (SARS-COV1 and MERS) have protracted recovery time-courses with significant respiratory morbidity,1 suggesting the same may be true for COVID-19. A service evaluation was therefore undertaken to evaluate the short-term effects of COVID-19. Methods Respiratory specialist doctors conducted structured telephone consultations of patients admitted between 17th March 2020 and 2nd May 2020 with a diagnosis of COVID-19 pneumonia at a teaching hospital. Using time from discharge patients were allocated into 3 groups: 3–4 weeks, 4–5 weeks and 5+. Patients were asked to recall acute COVID-19 symptoms, current symptoms, activity levels, and exercise capacity after discharge. Exercise capacity was quantified by self-assessment of walking distance on flat (metres), stairs (flights). Patient reported outcome measures (MRC dyspnoea scale and WHO performance status) were also collated. Results A total of 102 patients were screened, 70 were included in the study, with the rest being unreachable (n=32) Cough, dyspnoea, fever and lethargy were the most common symptoms at time of admission. All these symptoms, except lethargy, improved following discharge (figure 1). Prevalence in the 5+ week cohort of other symptoms is as follows: dyspnoea 35.7%, cough 11.5%, fever 0%; however, 70% of patients had at least 1 symptom 5 weeks after discharge. Self-reported exercise capacity and MRC dyspnoea score also improved after discharge. Despite this 21.4% of patients had a persistent impairment in walking ability on the flat, 17.8% in stair-climbing with 28.5% persistent deficit in MRC dyspnoea score after 5 weeks. In contrast 40% of patients had a deficit in WHO performance status and this was not affected by time after discharge. In conclusion patients did improve following discharge from hospital for COVID-19 pneumonia, however many were left with residual symptoms and a functional deficit in short term (5 weeks). It remains to be seen whether this results in long term health problems. *highlights joint authorship Reference Hui DS, Wong KT, Ko FW, et al. The 1-year impact of severe acute respiratory syndrome on pulmonary function, exercise capacity, and quality of life in a cohort of survivors. Chest. 2005;128(4):2247–2261.