Results
A total of 269 COVID-19 patients were discharged from our hospital
between 1 April and 1 September 2020 and 70 patients were included in
the study (Figure 1). The demographic and clinical characteristics of
the participants are shown in table 1. Median age of participants was 56
years, and 60 (75%) of them were male. Most common comorbid diseases
were hypertension (40%) and DM (33%). Thirty-one patients (44%) were
admitted to the ICU and the median length of ICU stay was 9 days. Median
length of hospital stay was 12 days and the time from the onset of
symptoms to follow-up visit was 198 days.
ICU patients had a higher median CT score at admission than non-ICU
patients [17 (11-24) vs. 11 (10-15) respectively, p=0.002]. CT scores
at the follow-up visit remained higher in ICU patients. All of the
patients had at least one CT finding at admission, 20 ICU patients
(65%) and 12 non-ICU patients (31%) had at least one CT finding in the
follow-up CT (p=0.005) (Table 2). The most common CT finding was ground
glass opacity (GGO) in the follow-up CT, followed by subpleural lines
and irregular lines.
79% of participants had at least one persistent symptom. Individuals
who were discharged from the ICU had a higher percentage of persistent
symptoms, 90% vs 67% (p=0.033). Effort dyspnea was the most common
persistent symptom followed by fatigue and muscle weakness (e–Table 1).
Women had a higher percentage of persistent symptoms than men (e–Table
2).
A total of 65 participants (93%) completed the pulmonary function test
(PFT) and 5 participants were unable to complete the test. Results of
PFT are summarized at table 3. Forced vital capacity (FVC), peak
expiratory flow (PEF) and peak inspiratory flow (PIF) were the most
commonly affected parameters in ICU patients. PEF and PIF were also the
two most commonly affected parameters in non-ICU patients. Higher CT
scores at follow-up visits were found to be associated with impairment
of PFT (Table 4).
The median distance of 6-minute walk tests was similar in both groups;
445m in ICU patients, and 461 meters in non-ICU patients. When
participants were stratified into age and weight, 13 participants (42%)
in the ICU group, and 11 participants (28%) in the non-ICU group, were
below 80% of the expected distance.
Assessment of quality of life, by SF-36, were similar in the two groups.
Social functioning, role limitation due to physical and emotional
problems were the most affected SF-36 categories (Table 3). The quality
of life scores were lower in female participants than male participants
(e–Table 3).
When the presence of ICU admission, age, gender, and CT score at
admission were introduced into a logistic regression model, only
patients age (OR 1.08, 95% CI 1.02-1.15) and higher CT score at
admission (OR 1.13, 95% CI 1.01-1.27) were independent risk factors for
having at least one radiological abnormality at a follow-up CT.