Figures
- FIGURE 1
Flowchart of the patients in the CO-FLOW study during the interim analysis.
- FIGURE 2
Symptom prevalence over time. Prevalence of COVID-19-related symptoms at 3-, 6- and 12-month follow-up in patients after hospitalisation for COVID-19, sorted by symptoms cluster and from most to least frequently reported. Data are presented as percentage of patients with symptoms. Symptoms marked with ◊ declined significantly over time based on generalised estimating equation analyses, with follow-up visit as fixed factor and symptom (yes/no) at each follow-up visit as dependent variable.
- FIGURE 3
Venn diagrams showing overlap between the symptom clusters (physical symptoms, cognitive symptoms, fatigue symptoms and respiratory symptoms) for the entire cohort, males and females. Data are presented as n (%) indicating the number of patients with symptoms.
- FIGURE 4
Forest plot of the patient and admission characteristics associated with the most prevalent symptoms for the a) physical, b) fatigue and c) cognitive symptoms clusters obtained by multivariable logistic regression analyses. LOS: length of stay.
Tables
- TABLE 1
Patient and clinical characteristics of patients hospitalised for COVID-19
n# All (n=492) Patient characteristic Age years 60.2±10.7 Sex, male 335 (68.1) BMI kg·m−2 437 29.3±5.5 Migration background 491 European 373 (76.0) Dutch Caribbean 61 (12.4) Asian 25 (5.1) Turkish 18 (3.7) (North) African 14 (2.9) Pre-COVID education 489 Low 166 (33.9) Middle 172 (35.2) High 151 (30.9) Pre-COVID employment 490 Unemployed 77 (15.7) Employed 297 (60.6) Retired 116 (23.7) Smoking status 491 Never 211 (43.0) Former 270 (55.0) Current 10 (2.0) Comorbidities ≥1 403 (81.9) Obesity (BMI ≥30) 190 (38.6) Diabetes 95 (19.3) Cardiovascular disease/hypertension 192 (39.0) Pulmonary disease 119 (24.2) Renal disease 46 (9.3) Gastrointestinal disease 22 (4.5) Neuromuscular disease 49 (10.0) Malignancy 56 (11.4) Autoimmune/inflammatory disease 54 (11.0) Mental disorder 25 (5.1) In-hospital characteristics PCR confirmed SARS-CoV-2 485 (98.6) Serology confirmed SARS-CoV-2 7 (1.4) Laboratory values Creatinine µmol·L−1 471 82.0 (69.0–100.0) (CKD-EPI) eGFR mL·min−1 456 82.0 (66.0–90.0) CRP mg·L−1 467 85.0 (47.0–154.0) Ferritin µg·L−1 284 832.5 (443.5–1613.3) ALAT U·L−1 457 37.0 (26.0–56.0) Haemoglobin mmol·L−1 468 8.6 (7.9–9.2) MCV fL 461 89.0 (85.0–91.0) Thrombocytes, 10⁹/L 463 211.0 (159.0–276.0) Lymphocytes absolute count, 10⁹/L 325 0.9 (0.6–1.1) D-dimer mg·L−1 237 1.1 (0.6–380.0) NT-proBNP pmol·mL−1 90 18.5 (8.8–48.0) IL-6 pmol·mL−1 36 55.5 (28.0–179.0) Chest radiograph abnormalities 468 Normal 59 (12.6) Moderate 99 (21.2) Severe 310 (66.2) Thrombosis 484 79 (16.3) Delirium 477 121 (25.4) Requiring oxygen supplementation 492 474 (96.3) Requiring high-flow nasal cannula 462 150 (32.5) ICU admission 199 (40.4) Invasive mechanical ventilation 175 (35.6) Length of intubation days 167 14.0 (8.0–27.0) Tracheostomy 482 64 (13.3) Length of ICU stay days 197 17.0 (9.0–30.5) Length of hospital stay days 11.0 (6.0–27.0) COVID-19 directed treatment 466 None 109 (23.4) (Hydroxy)chloroquine 14 (3.0) Steroids 330 (70.8) Antivirals 69 (14.8) Anti-inflammatory (IL-6) treatment 54 (11.6) Convalescent plasma 8 (1.7) Monoclonal antibodies 0 (0.0) Time interval between discharge and follow-up visit 3-month visit, days 385 94.7±22.8 6-month visit, days 483 184.8±27.9 12-month visit, days 271 368.3±17.3 Data are presented as n (%), mean±sd or, for non-normally distributed variables, median (interquartile range). BMI: body mass index; PCR: polymerase chain reaction; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; NT-proBNP: N-terminal pro-brain natriuretic peptide; IL-6: interleukin-6; ICU: intensive care unit. #: adjusted n is presented for variables with a total number of patients <492.
- TABLE 2
Prevalence of COVID-19-related symptoms at 3-, 6- and 12-month follow-up in patients after hospitalisation for COVID-19
3 months (n=385) n (%) 6 months (n=483) n (%) 12 months (n=271) n (%) p-value# Physical symptoms Muscle weakness 220 (57.1) 234 (48.4) 111 (41.0) <0.001 Balance problems/dizziness 169 (43.8) 213 (44.4) 116 (42.8) 0.922 Joint pain 166 (43.2) 201 (41.6) 111 (41.0) 0.352 Tingling/numbness in extremities 147 (36.8) 163 (33.9) 86 (32.1) 0.291 Hair loss 138 (35.9) 98 (20.3) 35 (12.9) <0.001 Headache# 33 (31.4) 57 (26.1) 29 (18.6) 0.579 Chest pain# 29 (29.0) 40 (18.4) 28 (17.8) 0.069 Skin rash 99 (25.7) 132 (27.4) 82 (30.3) 0.587 Vision problems 97 (25.2) 148 (30.6) 78 (28.8) 0.023 Hoarseness 91 (23.6) 125 (25.9) 57 (21.0) 0.088 Anosmia 84 (21.9) 93 (19.3) 53 (19.6) 0.369 Ageusia 82 (21.2) 94 (19.5) 52 (19.2) 0.185 Stool problems 68 (17.7) 89 (18.5) 41 (15.1) 0.547 Claudication 54 (14.1) 68 (14.1) 27 (10.0) 0.116 Hearing problems 52 (13.5) 70 (14.5) 53 (19.6) 0.059 Miction problems 37 (9.7) 58 (12.1) 34 (12.5) 0.269 Respiratory symptoms Exertional dyspnoea 315 (81.8) 345 (71.4) 171 (63.1) <0.001 Dyspnoea# 78 (66.1) 114 (51.8) 83 (52.9) 0.003 Cough 112 (29.0) 119 (24.7) 66 (24.4) 0.329 Phlegm 98 (25.5) 117 (24.2) 67 (24.7) 0.727 Fatigue symptoms Fatigue 243 (64.5) 277 (63.1) 156 (60.2) 0.932 Sleeping problems 141 (36.5) 172 (35.6) 96 (35.4) 0.777 Cognitive symptoms Memory problems 211 (54.7) 271 (56.1) 158 (58.3) 0.144 Concentration problems 206 (53.4) 249 (51.6) 140 (51.7) 0.826 Sensory overload# 44 (45.5) 93 (43.9) 58 (36.7) 0.503 Anxiety/nightmares 56 (14.5) 72 (14.9) 40 (14.8) 0.785 Data are presented as n (%) indicating the number of patients with symptoms. p-values are obtained from Generalised Estimating Equation analyses, with follow-up visit as fixed factor and symptom (yes/no) at each follow-up visit as dependent variable. Bonferroni correction was applied for multiple testing; a p-value <0.002 was considered statistically significant (printed in bold). #: symptoms headache, chest pain, dyspnoea and sensory overload were added at a later stage, resulting in lower total numbers.
Supplementary Material
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Supplementary material 00355-2022.supplement
