Long-Term Effects of COVID-19 and Health-Related Quality of Life of Mild Cases an outpatient clinic

Main Article Content

Patrícia Candido Luís Otávio Alves Mendonça Paulo Otávio Lopes Pereira Elisa de Oliveira Valente Camila Costa de Morais Michael Silva Miranda Samuel Câmara Poliana Romão Eunice Higuchi João Pádua Manzano Katia Ramos Moreira Leite Ruan Pimenta Victor Srougi Sabrina Reis, MSc; Ph.D. http://orcid.org/0000-0002-3564-3597

Abstract

Background/aim: The clinical spectrum of COVID-19 infection ranges from asymptomatic infection to deadly and potentially lethal disease. Although some studies have been performed, data on the long-term effects and persistent symptoms after COVID-19 are limited. We aimed to evaluate the long-term effects in an adult population with SARS-CoV-2 infection treated in a patient clinic.


Materials and Methods: The study included a random sample of 231 adults (≥18 years) with a positive outpatient test result for SARS-CoV-2 who were not hospitalized. We adapted six quality of life questionnaires already validated. We performed an overall analysis of the frequency of responses and then statistically correlated the frequency of symptoms with gender, age, and presence of comorbidities. Results: The mean age was 40.25 years old, 62.8% were women, who had a higher frequency of various symptoms (p < 0.05). We found a higher frequency of symptoms associated with SARS-CoV-2 in patients under 40 years: Shortness of breath at rest (p = 0.004), Shortness of breath when walking at your own pace (p = 0.007), Shortness of breath when performing sexual activities (p = 0.047), Tired or low energy (p = 0.002), Difficulty in concentrating (p = 0.047), Heart change even without physical exertion (p = 0.005), Headache (p = 0.007) and Memory problems (p = 0.031).


Conclusion: Our study showed that individuals that required no hospitalization might have persistent quality of life symptoms after recovery from COVID-19 infection. Therefore, there is a need for long-term follow-up and rehabilitation strategies for patients should be developed.

Keywords: COVID-19, quality of life, symptoms

Article Details

How to Cite
CANDIDO, Patrícia et al. Long-Term Effects of COVID-19 and Health-Related Quality of Life of Mild Cases an outpatient clinic. Medical Research Archives, [S.l.], v. 11, n. 11, nov. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4774>. Date accessed: 21 nov. 2024. doi: https://doi.org/10.18103/mra.v11i11.4774.
Section
Research Articles

References

1. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. Mar 19 2020;91(1):157-160. doi:10.23750/abm.v91i1.9397

2. Greenhalgh T, Knight M, A'Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. Aug 11 2020;370:m3026. doi:10.1136/bmj.m3026

3. Lippi G, Sanchis-Gomar F, Henry BM. COVID-19 and its long-term sequelae: what do we know in 2023? Pol Arch Intern Med. Apr 19 2023;133(4)doi:10.20452/pamw.16402

4. StatPearls. 2023.

5. Zarei M, Bose D, Nouri-Vaskeh M, Tajiknia V, Zand R, Ghasemi M. Long-term side effects and lingering symptoms post COVID-19 recovery. Rev Med Virol. 05 2022;32(3):e2289. doi:10.1002/rmv.2289

6. Carfì A, Bernabei R, Landi F, Group GAC-P-ACS. Persistent Symptoms in Patients After Acute COVID-19. JAMA. Aug 11 2020;324 (6):603-605. doi:10.1001/jama.2020.12603

7. Szende A, Janssen B, Cabases J. Self-Reported Population Health: An International Perspective based on EQ-5D. 2014.

8. Rolfson DB, Majumdar SR, Tsuyuki RT, Tahir A, Rockwood K. Validity and reliability of the Edmonton Frail Scale. Age Ageing. Sep 2006;35(5):526-9. doi:10.1093/ageing/afl041

9. Swigris JJ, Han M, Vij R, et al. The UCSD shortness of breath questionnaire has longitudinal construct validity in idiopathic pulmonary fibrosis. Respir Med. Oct 2012;106 (10):1447-55. doi:10.1016/j.rmed.2012.06.018

10. Solutions ACAIMH. PHQ-9 Depression Scale | University of Washington AIMS Center. https://aims.uw.edu/resource-library/phq-9-depression-scale

11. Calc M. PHQ-9 (Patient Health Questionnaire-9) - MDCalc. @mdcalc. https://www.mdcalc.com/calc/1725/phq9-patient-health-questionnaire9#creator-insights

12. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. May 1989;28(2):193-213. doi:10.1016/0165-1781 (89)90047-4

13. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 08 09 2021;11 (1):16144. doi:10.1038/s41598-021-95565-8

14. Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V, et al. Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis. Eur J Intern Med. 10 2021;92:55-70. doi:10.1016/j.ejim.2021.06.009

15. Augustin M, Schommers P, Stecher M, et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Eur. Jul 2021;6:100122. doi:10.1016/j.lanepe .2021.100122

16. Burke RM, Killerby ME, Newton S, et al. Symptom Profiles of a Convenience Sample of Patients with COVID-19 - United States, January-April 2020. MMWR Morb Mortal Wkly Rep. Jul 17 2020;69(28):904-908. doi:10. 15585/mmwr.mm6928a2

17. Petersen MS, Kristiansen MF, Hanusson KD, et al. Long COVID in the Faroe Islands: A Longitudinal Study Among Nonhospitalized Patients. Clin Infect Dis. 12 06 2021;73 (11):e4058-e4063. doi:10.1093/cid/ciaa1792

18. Stavem K, Ghanima W, Olsen MK, Gilboe HM, Einvik G. Prevalence and Determinants of Fatigue after COVID-19 in Non-Hospitalized Subjects: A Population-Based Study. Int J Environ Res Public Health. 02 19 2021;18 (4)doi:10.3390/ijerph18042030

19. Townsend L, Dyer AH, Jones K, et al. Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLoS One. 2020;15 (11):e0240784. doi:10.1371/journal.pone.0240784

20. Z C-B, I M, J S, et al. Brain Fog and Quality of Life at Work in Non-Hospitalized Patients after COVID-19. International journal of environmental research and public health. 10/06/2022 2022;19(19)doi:10.3390/ijerph19 1912816

21. Mazza MG, De Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain Behav Immun. 10 2020; 89:594-600. doi:10.1016/j.bbi.2020.07.037

22. Xiong Q, Xu M, Li J, et al. Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clin Microbiol Infect. Jan 2021;27(1):89-95. doi:10. 1016/j.cmi.2020.09.023

23. Bai F, Tomasoni D, Falcinella C, et al. Female gender is associated with long COVID syndrome: a prospective cohort study. Clin Microbiol Infect. Apr 2022;28(4):611.e9-611.e 16. doi:10.1016/j.cmi.2021.11.002

24. Graham EL, Clark JR, Orban ZS, et al. Persistent neurologic symptoms and cognitive dysfunction in non-hospitalized Covid-19 "long haulers". Ann Clin Transl Neurol. 05 2021;8(5):1073-1085. doi:10.1002 /acn3.51350

25. Mohamed MS, Moulin TC, Schiöth HB. Sex differences in COVID-19: the role of androgens in disease severity and progression. Endocrine. 01 2021;71(1):3-8. doi:10.1007/s12020-020-02536-6

26. Bienvenu LA, Noonan J, Wang X, Peter K. Higher mortality of COVID-19 in males: sex differences in immune response and cardiovascular comorbidities. Cardiovasc Res. 12 01 2020;116(14):2197-2206. doi:10.1093/ cvr/cvaa284

27. Zeng F, Dai C, Cai P, et al. A comparison study of SARS-CoV-2 IgG antibody between male and female COVID-19 patients: A possible reason underlying different outcome between sex. J Med Virol. 10 2020;92 (10):2050-2054. doi:10.1002/jmv.25989

28. Rogers JP, Chesney E, Oliver D, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 07 2020;7(7):611-627. doi:10.1016/S2215-0366 (20)30203-0

29. Søraas A, Kalleberg KT, Dahl JA, et al. Persisting symptoms three to eight months after non-hospitalized COVID-19, a prospective cohort study. PLoS One. 2021;16 (8):e0256142. doi:10.1371/journal.pone.0256142

30. Hellmuth J, Barnett TA, Asken BM, et al. Persistent COVID-19-associated neurocognitive ymptoms in non-hospitalized patients. J Neurovirol. 02 2021;27(1):191-195. doi:10. 1007/s13365-021-00954-4

31. Fernández-de-Las-Peñas C, Navarro-Santana M, Gómez-Mayordomo V, et al. Headache as an acute and post-COVID-19 symptom in COVID-19 survivors: A meta-analysis of the current literature. Eur J Neurol. 11 2021;28(11):3820-3825. doi:10.1111/ene .15040

32. Afrin LB, Weinstock LB, Molderings GJ. Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome. Int J Infect Dis. Nov 2020;100:327-332. doi:10.1016/j.ijid.2020.09.016