Longitudinal medical subspecialty follow-up of critically and non-critically ill hospitalized COVID-19 survivors up to 24 months after discharge

• Published in: Internal and emergency medicine 2023-03, Vol.18 (2), p.477-486
• Main Authors: Musheyev, Benjamin, Boparai, Montek S., Kimura, Reona, Janowicz, Rebeca, Pamlanye, Stacey, Hou, Wei, Duong, Tim Q.
• Format: Article
• Language: English
• Subjects: Aftercare; Cognition; Comorbidity; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - therapy; COVID-19 : diagnosis; Follow-Up Studies; Hospitals; Humans; Im - Original; Intensive Care Units; Internal Medicine; management and prognosis; Medicine; Medicine & Public Health; Patient Discharge; Patients; Pulmonology; Retrospective Studies; SARS-CoV-2; Survivors
• ISSN: 1828-0447; 1970-9366
• DOI: 10.1007/s11739-023-03195-x

Medical specialty usage of COVID-19 survivors after hospital discharge is poorly understood. This study investigated medical specialty usage at 1–12 and 13–24 months post-hospital discharge in critically ill and non-critically ill COVID-19 survivors. This retrospective study followed ICU ( N  = 89) and non-ICU ( N  = 205) COVID-19 survivors who returned for follow-up within the Stony Brook Health System post-hospital discharge. Follow-up data including survival, hospital readmission, ongoing symptoms, medical specialty care use, and ICU status were examined 1–12 and 13–24 months after COVID-19 discharge. “New” (not previously seen) medical specialty usage was also identified. Essentially all (98%) patients survived. Hospital readmission was 34%, but functional status scores at discharge were not associated with hospital readmission. Many patients reported ongoing [neuromuscular (50%) respiratory (39%), chronic fatigue (35%), cardiovascular (30%), gastrointestinal (28%), neurocognitive (22%), genitourinary (22%), and mood-related (13%)] symptoms at least once 1–24 months after discharge. Common specialty follow-ups included cardiology (25%), vascular medicine (17%), urology (17%), neurology (16%), and pulmonology (14%), with some associated with pre-existing comorbidities and with COVID-19. Common new specialty visits were vascular medicine (11%), pulmonology (11%), and neurology (9%). ICU patients had more symptoms and follow-ups compared to the non-ICU patients. This study reported high incidence of persistent symptoms and medical specialty care needs in hospitalized COVID-19 survivors 1–24 months post-discharge. Some specialty care needs were COVID-19 related or exacerbated by COVID-19 disease while others were associated with pre-existing medical conditions. Longer follow-up studies of COVID-19 survivor medical care needs are necessary.