key: cord-0798022-44bkcq6d
authors: Chopra, Vineet; Flanders, Scott A.; O'Malley, Megan; Malani, Anurag N.; Prescott, Hallie C.
title: Sixty-Day Outcomes Among Patients Hospitalized With COVID-19
date: 2020-11-11
journal: Ann Intern Med
DOI: 10.7326/m20-5661
sha: dfbb7087cb1ffcbfddb50273c29c0073a6f3747f
doc_id: 798022
cord_uid: 44bkcq6d

nan

Cardiopulmonary symptoms (such as cough and dyspnea) were reported by 159 patients, including 92 with new or worsening symptoms and 65 with persistent loss of taste or smell. Fifty-eight patients reported new or worsening difficulty completing activities of daily living. Among 195 patients who were employed before hospitalization, 117 had returned to work whereas 78 could not because of ongoing health issues or job loss. Of the 117 patients who returned to work, 30 reported reduced hours or modified duties due to health reasons.

Nearly half of all patients (238 of 488) reported being emotionally affected by their health, and 28 sought care for mental health after discharge. Moreover, 179 patients reported at least a mild financial impact from their hospitalization, with 47 reporting use of most or all of their savings and 35 rationing food, heat, housing, or medications due to cost.

Discussion: In this multihospital cohort of patients hospitalized with COVID-19 in Michigan, nearly 1 in 3 patients died during hospitalization or within 60 days of discharge. For most patients who survived, ongoing morbidity, including the inability to return to normal activities, physical and emotional symptoms, and financial loss, was common (1). These data confirm that the toll of COVID-19 extends well beyond hospitalization, a finding consistent with longterm sequelae from sepsis (2) and other severe respiratory viral illnesses (3). Although most patients saw a primary care provider after discharge, 1 in 5 had no primary care follow-up visit within 60 days of discharge. Collectively, these findings suggest that better models to support COVID-19 survivors are necessary (4).

Our study has limitations. Although postdischarge chart review was completed for all patients, telephone contact occurred in fewer than half. Loss to follow-up may be nonrandom; thus, the proportion of patients who had adverse outcomes may be biased. We therefore report numbers of events, which should be interpreted as the minimum known number of patients with a given outcome. Despite these limitations, our study conveys that adverse events after COVID-19 hospitalization are common. Policies and clinical and research programs targeting these aspects are needed.

Gemelli Against COVID-19 Post-Acute Care Study Group

Enhancing recovery from sepsis: a review

Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: a systematic review and meta-analysis

Recovery from severe COVID-19: leveraging the lessons of survival from sepsis

The authors thank all the BCBSM Collaborative Quality Initiatives that partnered together on data collection and all the hospitals that volunteered to be part of MI-COVID19.