Table 2.
Physical health outcomes in COVID-19 survivors.
| Author | Study design | Country | Sample size (N) Male/Female |
Age (years) Mean (SD) |
Follow-up period month/or days Mean (SD) |
Hospitalization period (days) Mean (SD) |
Outcomes (Measurement tools) | Results (Mean, SD), Prevalence of outcomes n/N (%) |
||
|---|---|---|---|---|---|---|---|---|---|---|
| Qi et al. [12] | Retrospective cohort study | China | 80 48/32 |
64.88 (16.98) | 30 and 90 days after hospital discharge | 15 (4.5) | Independent functional status (FIM) ADL (Barthel index) Muscle strength (MRC score) Functional capacity (6MWT) |
Mean (SD) | 1 month | 3 months |
| Barthel index | ↑82.25 (10.55) | 86.26 (7.70)* | ||||||||
| FIM | ↑100.28 (13.30) | 103.82 (10.71) | ||||||||
| MRC | ↑49.95 (7.36)* | 50.67 (5.64) | ||||||||
| ICU-AW | ↓26 (34.21%) | 14 (18.42%) | ||||||||
| 6MWT | ↑280.08 (37.82)* | 357.57 (56.98)* | ||||||||
| Sonnweber et al. [13] | Prospective cohort study |
Austria | 109 65/44 |
58 (14) | 60 (12) days after symptom onset |
N/A | Performance evaluation (6MWT) |
Lower 6MWT in individuals with persisting hyper-ferritinemia (n = 12) (200 m) compared to patients without (n = 11) (400 m) Lower 6MWT in individuals with pathological CT findings (180 m) compared to without (426 m) (P = 0.011) |
||
| Huang et al. [14] | Retrospective cohort study | China | 57 26/31 |
46.72 (13.78) | 30 days after hospital discharge | 20.89 (7.22) | Respiratory muscle strength (PImax), (PEmax) Functional capacity (6MWT) |
Mean (SD) 6MWT 561.97 (45.29) Severe patients had significantly lower 6MWT vs. non-severe patients. |
||
| Daher et al. [15] | Case series | German | 33 22/11 |
64 (3) | 58.49 (17.82) days after hospital discharge | 15 (1.8) | Functional capacity (6MWT) Fatigue (Borg Scale) Tiredness, myalgia |
During follow-up ↓Fatigue 15/33 (45%) ↓Tiredness 15/33 (45%) ↓Myalgia 5/33 (15%) Median [IQR] 6MWT 380 m [80–470 m] |
||
| Arnold et al. [16] | Prospective cohort study | England | 110 68/42 |
59.64 (20.28) | 88.94 (12.77) days after symptom onset | 5 (4.5) | Fatigue, myalgia, arthralgia, sit to stand (face-to-face outpatient follow-up) | (%) ↓Fatigue (39%) ↓Myalgia (23%) * ↓Arthralgia (6%) * |
||
| Garrigues et al. [19] | Cohort study | France | 120 (24 in ICU group, 96 in Ward group) 75/45 |
63.2 (15.7) | 110.9 (11.1) days after hospital admission | 11.2 (13.4) | Fatigue, myalgia, professional and physical activities (short phone questionnaire) |
Persistent fatigue 66/120 (55%) Myalgia 19/120 (15.8%) Returned to work/Worked before hospitalization 38/56 (67.9%) Resumed sports/Practiced sports regularly before hospitalization 28/39 (71.8%) |
||
| Carfi et al. [20] | Retrospective cohort study | Italy | 143 90/53 |
56.5 (14.6) | 60.3 (13.6) days after symptom onset | 13.5 (9.7) | Fatigue, joint pain, myalgia (COVID-19 standardized questionnaire) |
During follow-up ↓Fatigue (53.1%) ↓Joint pain (27.3%) ↓Myalgia (6%) |
||
| Halpin et al. [21] | Cross-sectional study | England | 100 (19/13 in ICU group, 35/33 in Ward group) |
ICU patients: 58.85 (38.8) Ward patients: 60.61 (55.29) |
48 (10.3) days after hospital discharge | ICU patients: 12.71 (4.65) Ward patients: 8.26 (7.57) |
Fatigue (COVID-19 rehabilitation telephone screening tool, Likert scale) |
Fatigue 72% of ICU patients, 60.3% of Ward patients Did not return to work 60% of ICU patients 15% of Ward patients |
||
| Goertz et al. [22] | Retrospective cohort study | Netherlands, Belgium | 2113 310/1803 |
46.64 (11.12) | 79 (17) days after symptom Onset |
N/A | Fatigue, muscle pain, pain between shoulder blades, joint pain, chest tightness (questionnaires with yes/no items) | During follow-up ↓Fatigue 87% ↓Muscle pain 36% ↓Joint pain 22% ↓Pain between shoulder blades 33% ↓Chest tightness 44% |
||
| Mandal et al. [23] | Cross-sectional study | London, United Kingdom | 384 238/146 |
59.9 (16.1) |
53.29 (8.9) days after hospital discharge |
7.1 (5.02) | Fatigue (graded as absent or present on an 11-point scale) | Fatigue 69%. Patients graded their overall health recovery as 90% [IQR 75–100%] compared to 100% best health. |
||
| Townsend et al. [24] | Cross-sectional study | Ireland | 128 59/69 |
49.5 (15) | 73.75 (18.74) days after hospital discharge |
Non-severe fatigue group (n = 61): 11.61 (9.87) Severe fatigue group (n = 67): 10.47 (8.33) |
Fatigue (CFQ-11 questionnaire) |
Mean (SD) Fatigue 15.8 (5.9) Physical fatigue 11.38 (4.22) Psychological fatigue 4.72 (1.99) |
||
| Wang et al. [25] | Prospective cohort study | China | 131 59/72 |
49 (19.48) | 120 days post hospital discharge | 15.35 (5.2) | Myalgia, chest tightness, fatigue (customized questionnaire) | Fatigue 0 (0%) Chest tightness 1 (0.76%) Myalgia 0 (0%) |
||
| Kamal et al. [26] |
Cross-sectional study | Egypt | 287 103/184 |
32.3 (8.5) | >20 days from the last negative test | N/A | Fatigue, joint pain (Post-COVID-19 Symptoms Collect questionnaire) |
Fatigue 72.8% Joint pain 31.4% |
||
| Xiong et al. [27] | Prospective cohort study | China | 538 245/293 |
51.64 (15.6) | 98.05 (5.2) days after hospital discharge |
17.4 (10.4) | Fatigue, myalgia, arthralgia (small-scale clinical pretrial assessment) | N (%) Fatigue 152/538 (28.3%) * Myalgia 24 /538 (4.5%) * Arthralgia 41/538 (7.6%) * |
||
| Carvalho-Schneider et al. [30] | Prospective cohort study | France | 150 66/84 |
49 (15) | 32.7 (2.5) and 59.7 (1.7) days after symptom onset |
N/A | Asthenia (WHO performance status classification) Arthralgia, myalgia (standardized case report form completed) |
Day 30 (n=150) | Day 60 (n=130) | |
| Asthenia/myalgia | 54 (36.0%) | 28 (21.5%) | ||||||||
| Arthralgia | 13 (9.8%) | 21 (16.3%) | ||||||||
| Tomasoni et al. [31] | Cross-sectional study | Italy | 105 77/28 |
54.29 (16.53) | 45.64 (3.75) days after virological clearance |
8.35 (3.75) | Asthenia, pain (electronic case report form) |
Asthenia 33/105 (31.4%) Burning pain 11/105 (10.5%) |
||
| Mohamed- Hussein et al. [32] | Cross-sectional study | Egypt | 444 192/252 |
33.09 (12.09) | 35.31 (18.75) days after symptom onset | N/A | Post-COVID-19 Functional Status Scale (PCFS) | Functional limitations (%) Negligible (63.1%) Slight (14.1%) Moderate (2.5%) Severe (0.5%) No functional limitations (20%) 80% of patients who recovered from COVID-19 had some degree of functional restriction. |
||
| Yuan et al. [38] | Retrospective cohort study | China | 96 (27/27 in normal group, 20/22 in self-reported depression group) | Normal group = 45.2 (13.2), Self-reported depression group = 49.6 (13.2) | 14 days after discharge | Normal group = 24.4 (6.7) Self-reported depression group = 24.8 (6.5) |
Chest tightness (online questionnaire) | Patients reported chest tightness. | ||
| Landi et al. [72] | Prospective cohort study | Italy | 131 80/51 |
55.8 (14.8) | 55.8 (10.8) days after symptom onset | Patients with negative test: 12.1 (7.9) Positive test: 10.0 (6.5) |
Fatigue, joint pain | Fatigue 67/131 (51.1%) Joint pain 33/131 (25.1%) |
||
| Du et al. [73] | Retrospective cohort study | China | 126 61/65 |
62.83 (11.24) | 60 days after hospital discharge | 25.64 (11.24) | Fatigue, muscle or joint ache (standardized data collection form) |
Fatigue 49/126 (38.9%) Muscle/joint ache 16/126 (12.7%) |
||
| Ismael et al. [74] | Retrospective cohort study | Brazil | 895 354/541 |
40.79 (0.45) | 56.6 days after treatment | N/A | Fatigue, asthenia, myalgia, joint pain (online assessment, website/phone) | Fatigue 324 (36.94%) Asthenia 179 (20.41%) Myalgia 259 (29.57%) Joint pain 84 (9.58%) |
||
| Weerahandi et al. [75] | Prospective cohort study | New York, USA | 152 95/57 |
59.54 (12.72) | 36.64 (9.72) days after hospital discharge |
19.75 (15.71) | Physical health status (PROMIS Global Health-10 instrument) Survey completed by phone or online |
Mean (SD) ↓Physical health 43.8 (9.3) Indicating worse physical health after COVID-9 compared to baseline |
||
WHO: World Health Organization, ADL: activities of daily living, FIM: functional independence measure, MRC: Medical Research Council, 6MWT: Six-Minute Walk Test, ICU-AW: ICU-acquired weakness, CT: computed tomography, PCFS: Post-COVID-19 Functional Status Scale, PImax: maximum static inspiratory pressures; PEmax: maximum static expiratory pressures, PTSD: post-traumatic stress disorder, CFQ-11: Chalder Fatigue Score, FS-14: Fatigue Scale-14, MBS: Modified Borg Dyspnoea Scale, N/A: Not available, * Significantly different from the previous value.