Data on residual clinical damage after Coronavirus disease-2019 (COVID-19) are lacking. The aims of this study were to investigate whether COVID-19 leaves behind residual dysfunction, and identify patients who might benefit from post-discharge monitoring. All patients aged ≥18 years admitted to the Emergency Department (ED) for COVID-19, and evaluated at post-discharge follow-up between 7 April and 7 May, 2020, were enrolled. Primary outcome was need of follow-up , defined as the presence at follow-up of at least one among: respiratory rate (RR) >20 breaths/min, uncontrolled blood pressure (BP) requiring therapeutic change, moderate to very severe dyspnoea, malnutrition, or new-onset cognitive impairment, according to validated scores. Post-traumatic stress disorder (PTSD) served as secondary outcome. 185 patients were included. Median [interquartile range] time from hospital discharge to follow-up was 23 [ 20 – 29 ] days. 109 (58.9%) patients needed follow-up. At follow-up evaluation, 58 (31.3%) patients were dyspnoeic, 41 (22.2%) tachypnoeic, 10 (5.4%) malnourished, 106 (57.3%) at risk for malnutrition. Forty (21.6%) patients had uncontrolled BP requiring therapeutic change, and 47 (25.4%) new-onset cognitive impairment. PTSD was observed in 41 (22.2%) patients. At regression tree analysis, the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO 2 /FiO 2 ) and body mass index (BMI) at ED presentation, and age emerged as independent predictors of the need of follow-up . Patients with PaO 2 /FiO 2 <324 and BMI ≥33 Kg/m 2 had the highest odds to require follow-up. Among hospitalised patients, age ≥63 years, or age <63 plus non-invasive ventilation or diabetes identified those with the highest probability to need follow-up. PTSD was independently predicted by female gender and hospitalisation, the latter being protective (odds ratio, OR, 4.03, 95% confidence interval, CI, 1.76 to 9.47, p 0.0011; OR 0.37, 95% CI 0.14 to 0.92, p 0.033, respectively). COVID-19 leaves behind physical and psychological dysfunctions. Follow-up programmes should be implemented for selected patients.
【초록키워드】 COVID-19, Stress, PTSD, risk, oxygen, outcome, Probability, body mass index, therapeutic, Patient, Cognitive impairment, non-invasive ventilation, age, Hospitalised patients, Psychological, Follow-up, BMI, Malnutrition, hospitalisation, moderate, patients, Protective, Dyspnoea, Analysis, blood pressure, Emergency, Odds ratio, respiratory rate, dysfunction, 95% CI, 95% confidence interval, fractional inspired oxygen, hospital discharge, female gender, secondary outcome, disorder, Department, physical, benefit, enrolled, selected, defined, highest, predicted, identify, evaluated, diabete, independent predictor, PaO, tachypnoeic, 【제목키워드】 retrospective, residual, prospective observational cohort,