Risk factors associated with limited functional status among out-of-hospital patients 30 days and one year after a diagnosis of COVID-19: a cohort study

Abstract

Some people experience indefinitely persistent and disabling symptoms after acute COVID-19, even those who have not been hospitalized. The purpose of this study was to analyze the long-term health consequences at 30 days and one year among people who were not hospitalized after a diagnosis of COVID-19 and to analyze which variables predict limitations in functional status. This is a prospective cohort study with non-hospitalized adults infected with SARS-CoV-2 in the city of Londrina. After 30 days and one year of the acute symptoms of COVID-19, participants received the questionnaire through a social media that consisted of sociodemographic data and data on functionality through the Post-COVID Functional State Scale (PCFS)—the primary outcome of the study "presence of functional status limitation" was grouped into without functional status limitation (value: zero) and with functional limitation (value 1 to 4), fatigue through of the Fatigue Severity Scale (FSS) and dyspnea using the modified Borg scale. In the statistical analysis, multivariable analysis was performed. Statistical significance was set to 5%. Of 140 individuals analyzed, 103 (73.6%) were female with a median age of 35.5 (27–46) years. One year after the diagnosis of COVID-19, 44.3% had at least one self-reported symptom: memory loss (13.6%), gloominess (8.6%), anosmia (7.9%), body pain (7.1%), ageusia (7%), headache (6.4%), and cough (3.6%). According to the FSS and modified Borg scale 42.9% reported fatigue and 18.6% reported dyspnea, respectively. As for functionality, 40.7% reported some limitation, being 24.3% negligible functional limitation, 14.3% slight and 2.1% moderate according to the PCFS. There was a univariate association between the presence of limitation in the functional status with the female sex, diagnosis of anxiety and depression, presence of persistent symptoms after one year, fatigue and dyspnea. In the multivariable analysis, the predictor variables for functional status limitation were female sex, diagnosis of anxiety/depression, presence of at least one persistent symptom and fatigue one year after the diagnosis of COVID-19. One year after the disease, the patients presented functional limitation according to the PCFS, even without hospitalization. Risk factors associated with functional limitation include female sex, presence of fatigue, anxiety and depression, and at least one persistent symptom after one year of COVID-19 diagnosis.