Table 2.
Sequelae symptom, exercise capacity, and health-related quality of life among COVID-19 patients at 6-month and 12-month follow-up
|
Total (n=1276) |
Scale 3: not requiring supplemental oxygen (n=318) |
Scale 4: requiring supplemental oxygen (n=864) |
Scale 5–6: requiring HFNC, NIV, or IMV (n=94) |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6 month | 12 month | p value | 6 month | 12 month | p value | 6 month | 12 month | p value | 6 month | 12 month | p value | ||
| Sequelae symptom | |||||||||||||
| Any one of the following symptoms | 831/1227 (68%) | 620/1272 (49%) | <0·0001 | 211/307 (69%) | 151 (47%) | <0·0001 | 543/828 (66%) | 420/860 (49%) | <0·0001 | 77/92 (84%) | 49 (52%) | <0·0001 | |
| Fatigue or muscle weakness | 636/1230 (52%) | 255/1272 (20%) | <0·0001 | 158/307 (51%) | 65 (20%) | <0·0001 | 410/831 (49%) | 169/860 (20%) | <0·0001 | 68/92 (74%) | 21 (22%) | <0·0001 | |
| Sleep difficulties | 335/1230 (27%) | 215/1272 (17%) | <0·0001 | 84/307 (27%) | 49 (15%) | <0·0001 | 217/831 (26%) | 152/860 (18%) | <0·0001 | 34/92 (37%) | 14 (15%) | 0·0002 | |
| Hair loss | 268/1230 (22%) | 135/1272 (11%) | <0·0001 | 68/307 (22%) | 29 (9%) | <0·0001 | 177/831 (21%) | 98/860 (11%) | <0·0001 | 23/92 (25%) | 8 (9%) | 0·0003 | |
| Smell disorder | 135/1230 (11%) | 57/1272 (4%) | <0·0001 | 35/307 (11%) | 17 (5%) | 0·0030 | 86/831 (10%) | 34/860 (4%) | <0·0001 | 14/92 (15%) | 6 (6%) | 0·033 | |
| Palpitations | 118/1230 (10%) | 117/1272 (9%) | 0·88 | 32/307 (10%) | 23 (7%) | 0·12 | 72/831 (9%) | 87/860 (10%) | 0·17 | 14/92 (15%) | 7 (7%) | 0·09 | |
| Joint pain | 132/1225 (11%) | 157/1272 (12%) | 0·13 | 42/308 (14%) | 37 (12%) | 0·49 | 74/826 (9%) | 103/860 (12%) | 0·018 | 16/91 (18%) | 17 (18%) | 1·00 | |
| Decreased appetite | 97/1230 (8%) | 37/1272 (3%) | <0·0001 | 28/307 (9%) | 6 (2%) | <0·0001 | 58/831 (7%) | 27/860 (3%) | 0·0003 | 11/92 (12%) | 4 (4%) | 0·05 | |
| Taste disorder | 89/1230 (7%) | 37/1272 (3%) | <0·0001 | 22/307 (7%) | 6 (2%) | 0·0007 | 59/831 (7%) | 31/860 (4%) | 0·0007 | 8/92 (9%) | 0 | 0·0047 | |
| Dizziness | 69/1230 (6%) | 65/1272 (5%) | 0·56 | 22/307 (7%) | 16 (5%) | 0·24 | 41/831 (5%) | 40/860 (5%) | 0·71 | 6/92 (7%) | 9 (10%) | 0·41 | |
| Nausea or vomiting | 17/1229 (1%) | 11/1272 (1%) | 0·26 | 8/307 (3%) | 5 (2%) | 0·41 | 9/830 (1%) | 4/860 (0%) | 0·17 | 0/92 (0%) | 2 (2%) | 0·16 | |
| Chest pain | 57/1225 (5%) | 92/1272 (7%) | 0·0023 | 17/308 (6%) | 25 (8%) | 0·14 | 36/826 (4%) | 63/860 (7%) | 0·0055 | 4/91 (4%) | 4 (4%) | 1·00 | |
| Sore throat or difficult to swallow | 47/1230 (4%) | 44/1272 (3%) | 0·57 | 19/307 (6%) | 11 (3%) | 0·08 | 24/831 (3%) | 29/860 (3%) | 0·55 | 4/92 (4%) | 4 (4%) | 1·00 | |
| Skin rash | 39/1230 (3%) | 55/1272 (4%) | 0·10 | 12/307 (4%) | 15 (5%) | 0·53 | 23/831 (3%) | 38/860 (4%) | 0·05 | 4/92 (4%) | 2 (2%) | 0·41 | |
| Myalgia | 33/1225 (3%) | 54/1272 (4%) | 0·013 | 10/308 (3%) | 12 (4%) | 0·64 | 20/826 (2%) | 36/860 (4%) | 0·018 | 3/91 (3%) | 6 (6%) | 0·26 | |
| Headache | 25/1225 (2%) | 61/1272 (5%) | 0·0001 | 7/308 (2%) | 16 (5%) | 0·050 | 15/826 (2%) | 40/860 (5%) | 0·0010 | 3/91 (3%) | 5 (5%) | 0·48 | |
| mMRC score | .. | .. | 0·014 | .. | .. | 0·68 | .. | .. | 0·0015 | 0·83 | |||
| 0 | 872/1185 (74%) | 891/1271 (70%) | .. | 231/309 (75%) | 238/317 (75%) | .. | 591/792 (75%) | 596/860 (69%) | .. | 50/84 (60%) | 57 (61%) | .. | |
| ≥1 | 313/1185 (26%) | 380/1271 (30%) | .. | 78/309 (25%) | 79/317 (25%) | .. | 201/792 (25%) | 264/860 (31%) | .. | 34/84 (40%) | 37 (39%) | .. | |
| EQ-5D-5L questionnaire* | |||||||||||||
| Mobility: problems with walking around | 76/1191 (6%) | 115/1271 (9%) | 0·0058 | 17/310 (5%) | 24/317 (8%) | 0·37 | 45/796 (6%) | 83/860 (10%) | 0·0004 | 14/85 (16%) | 8 (9%) | 0·05 | |
| Personal care: problems with washing or dishing | 9/1191 (1%) | 20/1271 (2%) | 0·033 | 0/310 (0%) | 3/317 (1%) | 0·08 | 8/796 (1%) | 13/860 (2%) | 0·20 | 1/85 (1%) | 4 (4%) | 0·32 | |
| Usual activity: problems with usual activity | 18/1182 (2%) | 18/1271 (1%) | 0·86 | 3/309 (1%) | 2/317 (1%) | 0·56 | 11/789 (1%) | 13/860 (2%) | 0·68 | 4/84 (5%) | 3 (3%) | 0·32 | |
| Pain or discomfort | 321/1186 (27%) | 371/1271 (29%) | 0·13 | 84/307 (27%) | 84/317 (26%) | 0·76 | 201/794 (25%) | 255/860 (30%) | 0·020 | 36/85 (42%) | 32 (34%) | 0·37 | |
| Anxiety or depression | 274/1187 (23%) | 331/1271 (26%) | 0·015 | 74/309 (24%) | 78/317 (25%) | 0·83 | 170/794 (21%) | 226/860 (26%) | 0·0013 | 30/84 (36%) | 27 (29%) | 0·32 | |
| Quality of life† | 80·0 (75·0–90·0) | 80·0 (70·0–90·0) | 0·044 | 80·0 (70·0–90·0) | 80·0 (70·0–90·0) | 0·91 | 80·0 (75·0–90·0) | 80·0 (75·0–90·0) | 0·0058 | 80·0 (70·0–85·0) | 80·0 (70·0–85·0) | 0·38 | |
| Distance walked in 6 min, m | 495·0 (450·0–540·0) | 495·0 (443·0–544·0) | 0·26 | 491·0 (450·0–540·0) | 494·0 (438·5–540·5) | 0·59 | 496·0 (450·0–540·0) | 495·0 (442·0–544·0) | 0·76 | 495·0 (430·0–526·0) | 496·5 (455·0–552·0) | 0·023 | |
| Percentage of predicted value‡ | 88·0 (79·5–96·4) | 90·0 (81·3–98·6) | <0·0001 | 86·9 (78·5–95·2) | 89·1 (80·5–96·8) | 0·0028 | 88·6 (80·5–97·2) | 90·6 (81·8–99·8) | <0·0001 | 82·4 (75·2–92·3) | 87·9 (80·1–98·1) | 0·0006 | |
| Less than lower limit of the normal range§ | 174/1254 (14%) | 147/1248 (12%) | 0·033 | 51/313 (16%) | 40/308 (13%) | 0·09 | 100/851 (12%) | 91/850 (11%) | 0·28 | 23/90 (26%) | 16/90 (18%) | 0·20 | |
Data are median (IQR), n (%), or n/N (%) when data are missing. The differing denominators used indicate missing data. p value indicates the comparison of consequences between 6 months and 12 months in total or each category of scale. HFNC=high-flow nasal cannula for oxygen therapy. NIV=non-invasive ventilation. IMV=invasive mechanical ventilation. mMRC=modified British Medical Research Council. EQ-5D-5L=EuroQol five-dimension five-level questionnaire.
*
Detailed results of EQ-5D-5L questionnaire among COVID-19 patients are shown in the appendix (pp 21–22).
†
Quality of life was assessed using the EuroQol Visual Analogue Scale, ranging from 0 (worst imaginable health) to 100 (best imaginable health).
‡
Predicted values were calculated according to the method of Enright and Sherrill.
§
The lower limit of the normal range was calculated by subtracting 153 m from the predicted value for men or by subtracting 139 m for women.