Short-term outpatient follow-up of COVID-19 patients: A multidisciplinary approach.

Autor:	de Graaf MA; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, the Netherlands., Antoni ML; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, the Netherlands., Ter Kuile MM; Department of Gynaecology, Leiden University Medical Center, the Netherlands., Arbous MS; Department of Intensive Care, Leiden University Medical Center, the Netherlands., Duinisveld AJF; Department of Pulmonary Diseases, Leiden University Medical Center, the Netherlands., Feltkamp MCW; Department of Medical Microbiology, Leiden University Medical Center, the Netherlands., Groeneveld GH; Department of Infectious Diseases, Leiden University Medical Center, the Netherlands., Hinnen SCH; Department of Oncology, Leiden University Medical Center, the Netherlands., Janssen VR; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, the Netherlands., Lijfering WM; Department of Clinical Epidemiology, Leiden University Medical Center, the Netherlands., Omara S; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, the Netherlands., Postmus PE; Department of Pulmonary Diseases, Leiden University Medical Center, the Netherlands., Ramai SRS; Department of Pulmonary Diseases, Leiden University Medical Center, the Netherlands., Rius-Ottenheim N; Department of Psychiatry, Leiden University Medical Center, the Netherlands., Schalij MJ; Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333ZA Leiden, the Netherlands., Schiemanck SK; Department of Rehabilitation Medicine, Leiden University Medical Center, the Netherlands., Smid L; Department of Infectious Diseases, Leiden University Medical Center, the Netherlands., Stöger JL; Department of Radiology, Leiden University Medical Center, the Netherlands., Visser LG; Department of Infectious Diseases, Leiden University Medical Center, the Netherlands., de Vries JJC; Department of Medical Microbiology, Leiden University Medical Center, the Netherlands., Wijngaarden MA; Department of Internal Medicine, section Geriatrics, Leiden University Medical Center, Leiden, the Netherlands., Geelhoed JJM; Department of Pulmonary Diseases, Leiden University Medical Center, the Netherlands., Roukens AHE; Department of Infectious Diseases, Leiden University Medical Center, the Netherlands.
Jazyk:	angličtina
Zdroj:	EClinicalMedicine [EClinicalMedicine] 2021 Feb; Vol. 32, pp. 100731. Date of Electronic Publication: 2021 Jan 28.
DOI:	10.1016/j.eclinm.2021.100731
Abstrakt:	Background: Short-term follow-up of COVID-19 patients reveals pulmonary dysfunction, myocardial damage and severe psychological distress. Little is known of the burden of these sequelae, and there are no clear recommendations for follow-up of COVID-19 patients.In this multi-disciplinary evaluation, cardiopulmonary function and psychological impairment after hospitalization for COVID-19 are mapped. Methods: We evaluated patients at our outpatient clinic 6 weeks after discharge. Cardiopulmonary function was measured by echocardiography, 24-hours ECG monitoring and pulmonary function testing. Psychological adjustment was measured using questionnaires and semi-structured clinical interviews. A comparison was made between patients admitted to the general ward and Intensive care unit (ICU), and between patients with a high versus low functional status. Findings: Eighty-one patients were included of whom 34 (41%) had been admitted to the ICU. New York Heart Association class II-III was present in 62% of the patients. Left ventricular function was normal in 78% of patients. ICU patients had a lower diffusion capacity (mean difference 12,5% P  = 0.01), lower forced expiratory volume in one second and forced vital capacity (mean difference 14.9%; P <0.001; 15.4%; P <0.001; respectively). Risk of depression, anxiety and PTSD were 17%, 5% and 10% respectively and similar for both ICU and non-ICU patients. Interpretation: Overall, most patients suffered from functional limitations. Dyspnea on exertion was most frequently reported, possibly related to decreased DLCOc. This could be caused by pulmonary fibrosis, which should be investigated in long-term follow-up. In addition, mechanical ventilation, deconditioning, or pulmonary embolism may play an important role. Competing Interests: There is no conflict of interest for the present manuscript. (© 2021 The Author(s).)
Databáze:	MEDLINE
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