Case series/case reports (Indigo)
In this paper, the authors systematically studied the long-term health sequelae of COVID-19 patients. All patients discharged after COVID-19 from Radboud University Medical Centre, Nijmegen, The Netherlands, were consecutively invited to a multidisciplinary outpatient facility. Non-admitted patients with mild disease but with symptoms persisting >6 weeks could also be referred by general practitioners. Patients underwent a standardised assessments including measurements of lung function, chest CT/X-ray, 6-minute walking test, body composition, and questionnaires on mental, cognitive, health status and quality of life (QoL). 124 patients (age 59±14 years, 60% male) were included; 27 with mild, 51 with moderate, 26 with severe and 20 with critical disease. Lung diffusion capacity was below the lower limit of normal in 42% of discharged patients. Ninety-nine percent of discharged patients had reduced ground-glass opacification on repeat CT imaging, and normal chest X-rays were found in 93% of patients with mild disease. Residual pulmonary parenchymal abnormalities were present in 91% of discharged patients, and correlated with reduced lung diffusion capacity. Twenty-two percent had low exercise capacity, 19% low fat-free mass index, and problems in mental and/or cognitive function were found in 36% of patients. Health status was generally poor, particularly in the domains of functional impairment (64%), fatigue (69%) and QoL (72%). The authors concluded that their comprehensive health assessment revealed severe problems in several health domains in a substantial number of ex-COVID-19 patients. Longer follow-up studies are warranted to elucidate natural trajectories and to find predictors of complicated long-term trajectories of recovery.