Dyspnea, pain, reduced mobility reported 1 year after COVID-19 hospitalization
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Key takeaways:
- One year after COVID-19 hospitalization, dyspnea, pain and impaired mobility were commonly reported.
- Comorbidities at the time of critical COVID-19 were linked to reduced mobility.
WASHINGTON — Dyspnea, pain and reduced mobility were frequently reported in survivors of COVID-19 1 year after hospitalization, according to an abstract presented at the American Thoracic Society International Conference.
“We interpret these findings to suggest that efforts to improve patients’ health post-COVID should focus on the prevention and treatment of breathlessness, pain and limited mobility,” Roseline Agyekum, BS, research specialist at the University of Pennsylvania and PharmD candidate, told Healio. “Furthermore, we believe our results dispute any notion that ‘long COVID’ is a problem of emotional wellbeing, and rather emphasize the physical and functional consequences of acute infection. We also believe that since these limitations are reported even by participants who were not critically ill that surveillance for such symptoms might be important regardless of the initial pneumonia severity.”
In a prospective cohort study, Agyekum and colleagues analyzed 62 patients 12 to 18 months after being hospitalized with COVID-19 between March 2020 and April 2021 to understand the prevalence of dyspnea and several measures of health-related quality of life. They also sought to find out if there are certain clinical variables linked to lower long-term functional status.
When assessing breathlessness, researchers used the Modified Medical Research Council (mMRC) Dyspnea Scale, which rates the severity of breathlessness from 0 (low severity) to 5 (high severity). For measures of health-related quality of life, including mobility, self-care, usual activities, pain and discomfort, and anxiety and depression, they used the European Quality of Life-Five Dimension Scale (EQ-5D).
Patients completed both assessments either in-person or over the phone.
Of the total cohort, 42% (95% CI, 30%-50%) had dyspnea with a score of at least 2 on the scale 12 to 18 months after their hospitalization. Further, a greater percentage of patients with moderate to severe dyspnea were Black than white (55% vs. 18%; P = .005).
Moderate to severe impairment in pain was reported in more than half of patients (59%; 95% CI, 46%-71%), and the same level of impairment in mobility was found in nearly half (49%; 95% CI, 36%-62%), according to researchers.
“Although we anticipated that participants might report breathlessness following COVID-19 hospitalization, we did not expect such a high proportion of patients to report pain and difficulty with mobility,” Agyekum told Healio.
Researchers found that lower mobility was linked to hypertension (P = .03) and diabetes (P = .01) at hospitalization; however, they did not find any variables related to the observed elevated degree in pain.
Furthermore, no outcomes at 12 to 18 months were found to be related to patients’ hypoxia levels in the hospital, according to the abstract.
“We were surprised that participants’ perception of breathlessness, mobility and pain limitations, was not associated with the severity of their COVID-19 pneumonia while hospitalized,” Agyekum told Healio. “Even those individuals who never required supplemental oxygen while hospitalized frequently reported breathlessness, pain and limited mobility. We also demonstrated that anxiety and depression were relatively infrequent complaints post COVID-19 and occurred at rates very similar to what has been reported in the overall population.”
In future studies, Agyekum recommends continued assessment of patients after their hospital discharge.
“It is becoming common for both observational and interventional studies to consider the post-hospital trajectory of patients, and to design ways to capture health information months after an acute pneumonia,” Agyekum told Healio.
For more information:
Roseline Agyekum, BS, can be reached at agyekum.roseline@pennmedicine.upenn.edu.