Follow-Up Study of the Cardiopulmonary and Psychological Outcomes of COVID-19 Survivors Six Months After Discharge in Sichuan, China

Shuiping Dai; Bennan Zhao; Dafeng Liu; Yongzhao Zhou; Yaling Liu; Lijuan Lan; Yalun Li; Wenxin Luo; Yilan Zeng; Weimin Li

doi:10.2147/IJGM.S337604

Follow-Up Study of the Cardiopulmonary and Psychological Outcomes of COVID-19 Survivors Six Months After Discharge in Sichuan, China

Int J Gen Med. 2021 Oct 27:14:7207-7217. doi: 10.2147/IJGM.S337604. eCollection 2021.

Authors

Shuiping Dai^#¹, Bennan Zhao^#², Dafeng Liu², Yongzhao Zhou³, Yaling Liu², Lijuan Lan², Yalun Li³, Wenxin Luo³, Yilan Zeng², Weimin Li³

Affiliations

¹ Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
² Department of Comprehensive Internal Medicine, The Public and Health Clinical Center of Chengdu, Chengdu, Sichuan, People's Republic of China.
³ Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Some studies have shown that patients with coronavirus disease 2019 (COVID-19) still have sequelae after discharge. However, little is known about the long-term physical and psychological sequelae of patients, especially factors that influenced the prognosis.

Patients and methods: Patients with COVID-19 were followed up for 6 months. The psychological status of patients was evaluated by DASS-21 questionnaire, while physical functions were determined using medical history, laboratory examination, thoracic computed tomography (CT), and echocardiography.

Results: Fifty patients infected with COVID-19 were enrolled, and 11 (22%) patients still showed symptoms related to COVID-19. The mean contents (cells/ul) of CD3+ cells, CD4+ and CD8+ T, B lymphocytes and NK cells of the survivors elevated significantly after 6-month discharge (P < 0.001). The frequency of ground-glass opacities and consolidations decreased from 90% to 42% (P < 0.001), and 54% to 20%, (P = 0.001), respectively, while the changes of reticulation and bronchiectasis were insignificant (P > 0.05). The frequency of left ventricular diastolic dysfunction decreased from 40% to 15% (P = 0.002). Depression was observed in 5 (12.5%) participants, stress in 3 (7.5%), anxiety in 6 (15%), and among them 1 (2.5%) showed extremely severe anxiety. Covariation analysis elucidated age might be a risk factor (OR: 1.09, 95% CI: 1.01-1.18, P = 0.038), while NK cell was a good prognostic factor for pulmonary recovery. The comorbidities were significantly positive correlated with persist pulmonary damage (r = 0.33, P = 0.020). Compared with patients with antiviral therapy, patients without antiviral therapy had higher anxiety score (3 vs 0, P = 0.033).

Conclusion: After 6-month discharge, the persisting cardiopulmonary damage was observed in recovery patients, and psychological implications should not be ignored. Age, comorbidities, NK cell and antiviral therapy might be associated with the prognosis of COVID-19.

Keywords: COVID-19; cardiopulmonary; follow-up; influence factors; psychology.