Follow-Ups on Persistent Symptoms and Pulmonary Function Among Post-Acute COVID-19 Patients: A Systematic Review and Meta-Analysis, 2021, Long et al

[Sly Saint]

Objective: As the number of recovering COVID-19 patients increases worldwide, the persistence of symptoms and signs through the post-acute phase indicates an urgent need for prolonged follow-up care. To explore existing data about post-acute COVID-19 syndrome, this meta-analysis assesses the prevalence of persistent manifestations in multiple systems and abnormalities in lung function, as well as their related risks in patients with various severities.

Methods: Articles about discharged COVID-19 patients (published from January 1, 2020 to February 23, 2021) were obtained by searching four databases. Cohort studies with follow-up periods >1 month post-discharge or >2 months post-admission were included.

Results: A total of 4,478 COVID-19 patients from 16 cohort studies were included in this meta-analysis. Fatigue or weakness (47%) were the most prevalent physical effects of post-acute COVID-19 syndrome, while psychosocial (28%) symptoms were the most common manifestations among several systems. Abnormalities in lung function of recovering patients, i.e., DLCO <80% (47%, 95% CI: 32–61%) persisted for long periods. Severe patients were more likely to present joint pain (OR 1.84, 95% CI: 1.11–3.04) and decreased lung functions compared with non-severe patients, with pooled ORs for abnormal TLC, FEV1, FVC, and DLCO of 3.05 (95% CI: 1.88–4.96), 2.72 (95% CI: 1.31–5.63), 2.52 (95% CI: 1.28–4.98), and 1.82 (95% CI: 1.32–2.50), respectively.

Conclusions: Our research indicates that patients recovering from COVID-19 manifest long-term, multi-system symptoms, and the adverse effects on psychosocial health and lung functions were the most extensive and persistent. These findings together may facilitate much needed in-depth study of clinical treatments for long-term, post-acute phase symptoms that affect a great number of recovering COVID-19 patients.


https://www.frontiersin.org/articles/10.3389/fmed.2021.702635/full

 

[Sly Saint]

unbelievably they cite Ray Perrin

Lopez et al. (3) reported more than 50 long-term symptoms of post-COVID-19 syndrome, among which fatigue (58%) was the most common, in agreement with our findings of a high prevalence of fatigue or weakness (47%). Previous work by Perrin and co-workers suggested that a subset of COVID-19 patients may develop chronic fatigue syndrome (CFS) similar to those reported to follow SARS and MERS (32). CFS is characterized by persistent or recurrent unexplained severe fatigue that is not improved by rest, and may be accompanied by manifestations such as myalgia, depression, and sleep disorder. Perrin and colleagues also recently proposed that CFS could be induced by SARS-CoV-2 invasion of olfactory neurons, which can result in congestion of the lymphatic duct and subsequent accumulation of toxic agents in the central nervous system (33), thus induction of lymphatic circulation might be an effective measure to alleviate CFS follow COVID-19.