key: cord-0751470-bw16s2h6
authors: Matteo, Tosato; Angelo, Carfì; Ilaria, Martis; Pais, Cristina; Francesca, Ciciarello; Elisabetta, Rota; Marcello, Tritto; Andrea, Salerno; Beatrice, Zazzara Maria; Maria, Martone Anna; Annamaria, Paglionico; Luca, Petricca; Vincenzo, Brandi; Gennaro, Capalbo; Anna, Picca; Riccardo, Calvani; Emanuele, Marzetti; Francesco, Landi
title: PREVALENCE AND PREDICTORS OF PERSISTENCE OF COVID-19 SYMPTOMS IN OLDER ADULTS: A SINGLE-CENTER STUDY
date: 2021-07-19
journal: J Am Med Dir Assoc
DOI: 10.1016/j.jamda.2021.07.003
sha: 4cde7eca04c495947bbbd8579bfd71455200ad42
doc_id: 751470
cord_uid: bw16s2h6

Objectives Symptom persistence weeks after laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance is a relatively common long-term complication of Coronavirus disease 2019 (COVID-19). Little is known about this phenomenon in older adults. The present study aimed at determining the prevalence of persistent symptoms among old COVID-19 survivors and identifying symptom patterns. Design Cross-sectional study. Setting and Participants We analyzed data collected in people 65 years and older (n=165) who were hospitalized for COVID-19 and then admitted to the Day Hospital Post-COVID 19 of the XXX between April and December 2020. All patients tested negative for SARS-CoV-2 and met the World Health Organization criteria for quarantine discontinuation. Measures Patients were offered multidisciplinary individualized assessments. The persistence of symptoms was evaluated on admission using a standardized questionnaire. Results The mean age was 73.1 ± 6.2 years (median 72, interquartile range 27), and 63 (38.4%) were women. The average time elapsed from hospital discharge was 76.8 ± 20.3 days (range 25−109 days). On admission, 137 (83%) patients reported at least 1 persistent symptom. Of these, over one third reported 1 or 2 symptoms and 46.3% had 3 or more symptoms. The rate of symptom persistence was not significantly different when patients were stratified according to median age. Compared with those with no persistent symptoms, patients with symptom persistence reported a greater number of symptoms during acute COVID-19 (5.3 ± 3.0 vs. 3.3 ± 2.0; p<0.001). The most commonly persistent symptoms were fatigue (53.1%), dyspnea (51.5%), joint pain (22.2%), and cough (16.7%). The likelihood of symptom persistence was higher in those who had experienced fatigue during acute COVID-19. Conclusions and implications Persistent symptoms are frequently experienced by older adults who have been hospitalized for COVID-19. Follow-up programs should be implemented to monitor and care for long-term COVID-19-related health issues.

Concerns are not only related to the acute phase of the disease, but also to its post-acute phase.

The recovery path from COVID-19 is variable and depends on age, pre-existing comorbidities as 39 well as the severity of acute disease. According to the World Health Organization (WHO), the 40 recovery time from COVID-19 is around 2 weeks in mild cases and 3 to 6 weeks in more severe 41 infections. 3 ,4 Yet, a considerable share of patients complain of COVID-19-related symptoms weeks 42 after disease onset, a condition known as post-acute COVID-19 syndrome. 5,6 Common long-43 lasting signs and symptoms include cough, fever, dyspnea, fatigue, musculoskeletal (myalgia, joint 44 pain) and gastrointestinal complaints, and anosmia/dysgeusia. [7] [8] [9] 45 Some information on the characteristics associated with COVID-19 symptom persistence in 46 the general population is available, but little is known about the condition in older adults. To start filling this gap in knowledge, we followed up older patients after hospital discharge and recovery All patients who met the WHO criteria for discontinuation of quarantine (i.e., more than 10 admitted to the Day Hospital Post-COVID-19. For the present study, analyses were conducted in patients 65 years and older (n=165). All patients lived in the community and were able to walk 122 Table 2 shows unadjusted and adjusted associations between potential risk factors and 123 persistent COVID-19-related symptoms. In the unadjusted model, a direct association was 124 determined between total number of persistent symptoms and some symptoms suffered during 125 acute COVID-19 (i.e., cough, fatigue, and dyspnea). Supplemental oxygen and prescription of

The present study showed that, among old patients who recovered from COVID-19, over 80% reported persistence of at least 1 symptom, particularly fatigue, dyspnea, joint pain, and be the main risk factor for persistent COVID-19-related symptoms. A longer time from acute 139 COVID-19, expressed as the days elapsed from hospital discharge, was associated with a lower 140 likelihood of suffering persistent symptoms.

During the last months, the post-COVID-19 syndrome has received a great deal of scientific 142 and media attention. 14-16 Indeed, COVID-19 has turned out to be a long-term illness for many challenging. Sudre et al. 19 found that advanced age, female sex, excessive body weight, and the 153 presence of more than 5 symptoms during the first week of acute COVID-19 were strong 154 predictors of symptom persistence. In a large cohort study, the severity of acute COVID-19 was 155 found to be the main risk factor for persistent COVID-19-related symptoms. 20 Our data suggest 156 that, in older adults, the presence of more symptoms during the acute phase of COVID-19 is severe acute respiratory syndrome. 23 The team of medical doctors who are mainly involved in 163 patient care has preferably been composed by infectious disease specialists, pneumologists, and 164 intensivists. However, considering the advanced age of the population at higher risk of negative 165 outcomes, the involvement of geriatricians for the correct evaluation and management of these 166 patients is important not only during acute COVID-19, but also in the post-acute phase. 24 The 167 geriatrician is the specialist who best can manage multiple health problems with great aptitude and 168 skill to care for multimorbid and complex patients. 25 The geriatrician is also well suited for the J o u r n a l P r e -p r o o f 

The effect of control strategies

Comorbidity and its Impact on Patients with COVID-19

COVID-19): A Review

Gemelli Against COVID-19 Post-Acute Care Team. Predictive 206 Factors for a New Positive Nasopharyngeal Swab Among Patients Recovered From

Gemelli Against COVID-19 Post-Acute Care Study Group

Persistent Symptoms in Patients After Acute COVID-19

Clinical characteristics of 138 hospitalized patients with 2019 novel 222 coronavirus-infected pneumonia in Wuhan, China

Facilities. J Am Med Dir Assoc 2020;21(11):1574-1576. doi: