Key Points Question What are the long-term health outcomes associated with COVID-19 infection 1 year after hospital discharge? Findings In this cohort study of 2433 patients who had been hospitalized with COVID-19, the most common symptoms at 1 year after discharge were fatigue, sweating, chest tightness, anxiety, and myalgia. Patients with severe disease had more postinfection symptoms and higher chronic obstructive pulmonary disease assessment test scores. Meaning This study reported prolonged symptoms of COVID-19 and found that severe disease during hospitalization was a risk factor for more symptoms and higher chronic obstructive pulmonary disease assessment test scores. This cohort study investigates 1-year health outcomes and their associated risk factors among COVID-19 survivors in Wuhan, China. Importance The long-term health outcomes and symptom burden of COVID-19 remain largely unclear. Objective To evaluate health outcomes of COVID-19 survivors 1 year after hospital discharge and to identify associated risk factors. Design, Setting, and Participants This retrospective, multicenter cohort study was conducted at 2 designated hospitals, Huoshenshan Hospital and Taikang Tongji Hospital, both in Wuhan, China. All adult patients with COVID-19 discharged between February 12 and April 10, 2020, were screened for eligibility. Of a consecutive sample of 3988 discharged patients, 1555 were excluded (796 declined to participate and 759 were unable to be contacted) and the remaining 2433 patients were enrolled. All patients were interviewed via telephone from March 1 to March 20, 2021. Statistical analysis was performed from March 28 to April 18, 2021. Exposures COVID-19. Main Outcomes and Measures All patients participated in telephone interviews using a series of questionnaires for evaluation of symptoms, along with a chronic obstructive pulmonary disease (COPD) assessment test (CAT). Logistic regression models were used to evaluate risk factors for fatigue, dyspnea, symptom burden, or higher CAT scores. Results Of 2433 patients at 1-year follow-up, 1205 (49.5%) were men and 680 (27.9%) were categorized into the severe disease group as defined by the World Health Organization guideline; the median (IQR) age was 60.0 (49.0-68.0) years. In total, 1095 patients (45.0%) reported at least 1 symptom. The most common symptoms included fatigue, sweating, chest tightness, anxiety, and myalgia. Older age (odds ratio [OR], 1.02; 95% CI, 1.01-1.02; P < .001), female sex (OR, 1.27; 95% CI, 1.06-1.52; P = .008), and severe disease during hospital stay (OR, 1.43; 95% CI, 1.18-1.74; P < .001) were associated with higher risks of fatigue. Older age (OR, 1.02; 95% CI, 1.01-1.03; P < .001) and severe disease (OR, 1.51; 95% CI, 1.14-1.99; P = .004) were associated with higher risks of having at least 3 symptoms. The median (IQR) CAT score was 2 (0-4), and a total of 161 patients (6.6%) had a CAT score of at least 10. Severe disease (OR, 1.84; 95% CI, 1.31-2.58; P < .001) and coexisting cerebrovascular diseases (OR, 1.95; 95% CI, 1.07-3.54; P = .03) were independent risk factors for CAT scores of at least 10. Conclusions and Relevance This study found that patients with COVID-19 with severe disease during hospitalization had more postinfection symptoms and higher CAT scores.
【초록키워드】 COVID-19, Risk factors, Anxiety, Hospitalized, Hospitalization, fatigue, hospital, Infection, Sex, Symptom, discharged patients, outcome, risk factor, Symptoms, discharge, cohort study, hospitals, COPD, Health, Regression model, Chest, Dyspnea, female, Patient, age, Follow-up, disease, questionnaire, pulmonary disease, retrospective, Analysis, exposure, Odds ratio, severe disease, Cerebrovascular disease, myalgia, Hospital stay, World Health Organization, higher risk, 95% CI, symptom burden, hospital discharge, measure, eligibility, participant, independent risk factor, Tongji Hospital, symptoms of COVID-19, finding, Huoshenshan Hospital, survivor, men, objective, setting, consecutive sample, Postinfection, multicenter cohort study, Wuhan, China, sweating, Result, enrolled, defined, identify, evaluate, reported, conducted, was performed, screened, median, were used, discharged, Importance, declined, chronic obstructive, had more, IQR, participated, patients with COVID-19, Point, Relevance, the median, were excluded, with COVID-19, 【제목키워드】 COVID-19, Wuhan, China, Year,