Clinical, sociodemographic and environmental factors impact post-COVID-19 syndrome

Sociodemographic and environmental factors are associated with incidence, severity, and mortality of COVID-19. However, little is known about the role of such factors in persisting symptoms among recovering patients. We designed a cohort study of hospitalized COVID-19 survivors to describe persisten...

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Bibliographic Details
Published in:	Journal of global health Vol. 12; p. 05029
Main Authors:	Ferreira, Juliana Carvalho, Moreira, Tiana C Lopes, de Araújo, Adriana Ladeira, Imamura, Marta, Damiano, Rodolfo F, Garcia, Michelle L, Sawamura, Marcio Vy, Pinna, Fabio R, Guedes, Bruno F, Gonçalves, Fabio A Rodrigues, Mancini, Marcio, Burdmann, Emmanuel A, da Silva Filho, Demóstenes Ferreira, Polizel, Jefferson Lordello, Bento, Ricardo F, Rocha, Vanderson, Nitrini, Ricardo, de Souza, Heraldo Possolo, Levin, Anna S, Kallas, Esper G, Forlenza, Orestes V, Busatto, Geraldo F, Batistella, Linamara R, de Carvalho, Carlos R Ribeiro, Mauad, Thais, Gouveia, Nelson
Format:	Journal Article
Language:	English
Published:	Scotland International Society of Global Health 09-08-2022
Subjects:	Aftercare Cohort Studies COVID-19 - complications Fatigue Female Humans Patient Discharge Post-Acute COVID-19 Syndrome Research Theme 1: COVID-19 Pandemic Risk Factors
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Summary:	Sociodemographic and environmental factors are associated with incidence, severity, and mortality of COVID-19. However, little is known about the role of such factors in persisting symptoms among recovering patients. We designed a cohort study of hospitalized COVID-19 survivors to describe persistent symptoms and identify factors associated with post-COVID-19 syndrome. We included patients hospitalized between March to August 2020 who were alive six months after hospitalization. We collected individual and clinical characteristics during hospitalization and at follow-up assessed ten symptoms with standardized scales, 19 yes/no symptoms, a functional status and a quality-of-life scale and performed four clinical tests. We examined individual exposure to greenspace and air pollution and considered neighbourhood´s population density and socioeconomic conditions as contextual factors in multilevel regression analysis. We included 749 patients with a median follow-up of 200 (IQR = 185-235) days, and 618 (83%) had at least one of the ten symptoms measured with scales. Pain (41%), fatigue (38%) and posttraumatic stress disorder (35%) were the most frequent. COVID-19 severity, comorbidities, BMI, female sex, younger age, and low socioeconomic position were associated with different symptoms. Exposure to ambient air pollution was associated with higher dyspnoea and fatigue scores and lower functional status. We identified a high frequency of persistent symptoms among COVID-19 survivors that were associated with clinical, sociodemographic, and environmental variables. These findings indicate that most patients recovering from COVID-19 will need post-discharge care, and an additional burden to health care systems, especially in LMICs, should be expected.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These senior authors contributed equally to this work These authors contributed equally to this work
ISSN:	2047-2978 2047-2986 2047-2986
DOI:	10.7189/jogh.12.05029