Evaluation of patients followed due to SARS-CoV-2 infection in terms of long-COVİD-19 syndrome

Objective: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, was an infectious disease primarily affecting the respiratory system, potentially leading to conditions like interstitial pneumonia and acute respiratory distress syndrome (ARDS). While extensive research focused on the acute phase of COVID-19 during the pandemic, there remained limited data on its medium- and long-term outcomes. Increasing reports described persistent and long-lasting effects after acute COVID-19 infection, suggesting similarities to post-acute viral syndromes observed in survivors of other virulent coronavirus outbreaks. This study aimed to identify and collect data on symptoms persisting in COVID-19 patients at the 1st, 3rd, 6th, and 12th months following acute infection. We utilized the PCFS functional limitation scale and the Short Form 36 (SF-36) quality of life survey to assess both the presence of functional limitations and the overall impact of COVID-19 infection on patients' quality of life. Material and Methods: This study included a total of 131 patients who tested positive for COVID-19 by polymerase chain reaction (PCR) test in nasopharyngeal swab samples monitored by the Department of Infectious Diseases and Clinical Microbiology of Çukurova University Faculty of Medicine. Of these, 67 were outpatients, 47 were initially hospitalized, and 17 were hospitalized in the intensive care unit. All patients were at least four weeks post-diagnosis at the time of enrollment. We recorded the following data for each patient: age, gender, comorbid diseases, date of COVID-19 diagnosis, initial symptoms, treatments received, and any complications that developed during follow-up. Patients were assessed at the time of enrollment and 1, 3, 6, and 12 months following their acute infection. Symptom status was determined, and functional limitations were assessed and recorded using the "Post-COVID Functional Status Scale" (PCFS). To enable comparison, patients also reported their functional status before COVID-19 infection. Additionally, we used the "SF-36 Quality of Life Survey" to evaluate patients' quality of life in the post-COVID period. Results: The mean age of the 131 patients was 43.7 ± 15.3 years (median: 45, range: 18-83), with 71 (54.2%) being male. Of the patients, 67 (51.1%) received outpatient treatment, 47 (35.9%) were hospitalized in general wards, and 17 (13%) were admitted to the intensive care unit (ICU). The most common persistent symptom across the 1st, 3rd, 6th, and 12th-month follow-ups was fatigue with exertion. Patients treated in the ICU exhibited a higher prevalence of long COVID symptoms. We also observed that quality of life and functional status were significantly poorer in patients previously treated in the ICU and general wards than those managed as outpatients. Conclusion: Our study demonstrates that patients hospitalized with COVID-19, particularly those admitted to the intensive care unit, were more severely impacted by the disease compared to those treated as outpatients. This is evidenced by a higher incidence of Long COVID symptoms and a greater decline in quality of life and functional status among hospitalized patients. Keywords: COVID-19, Long-COVID symptoms, post-COVID-19, Quality of life, PCFS