Long-COVID syndrome in hospitalized patients after 2 years of follow-up

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic affected many leading to higher mortality and morbidity worldwide. The post-COVID syndrome (PCS) is characterized by heterogeneous group of clinical manifestations which can frequently lead to a significant worsening in everyday life, working and social conditions. Methods: We prospectively examined in a cohort of patients discharged from our hospital “Saint Andrea”, Vercelli, Italy, from 10^th March 2020 to 15^th January 2021, with COVID-19 diagnosis during the first wave of pandemic the prevalence and characteristics of PCS after 2 years of follow-up. Results: Overall included patients were 306; prevalence of PCS after 2 years was 43.8%; the fatigue assessment scale (FAS) evidenced that only 8.5% of patients suffered from a severe fatigue with important limitations. Most frequently observed symptoms/conditions were: fatigue (38.2%), breathlessness (19.3%), “brain fog” (29.7%), sleeping disorders (28.8%), post-traumatic stress disorder (29.4%), anxiety (39.9%); only 7.2% of patients resumed the work without limitations or rest period. In multivariate analysis intensive care unit (ICU) admission [odds ratio (OR) =3.950; 95% confidence interval (CI): 2.466–8.112; P=0.002], length of hospitalization (OR =1.855; 95% CI: 1.248–5.223; P=0.004) and nosocomial infections (OR =2.556; 95% CI: 1.443–5.292; P<0.001) were predictive of PCS at 2 years in the study population. Conclusions: After 2 years of follow-up, the 43.8% of enrolled subjects suffered from the PCS, but only the 8.5% with severe limitations in everyday life. We expect these data to highlight the importance of clinical and non-clinical aspect following the PCS in hospitalized patients.