Comprehensive assessment of short- and long-term clinical outcomes of COVID-19 patients post discharge from a tertiary care designated COVID-19 hospital in South India

Background: The aim of our study was to describe the symptomatology, health consequences and sequalae upto one year after symptom onset among hospital survivors with COVID-19.Methods: A 3rd, 6th and 12-month follow-up of covid-19 survivors was done between 25-9-2020 and 24-9-2021. A 3rd month follow-up was done by telephonic conversation with the patients or care givers and their responses were recorded. At 6-month and 12-month follow-up visit, survivors were interviewed with questionnaires on symptoms and health related quality of life (HRQoL) and received a physical examination, a 6-minute walking test and other relevant investigations. The primary outcomes were symptoms, modified British Medical Council (mMRC) score, HRQoL and distance walked in 6 minutes (6MWD).Results: 196 COVID-19 survivors completed both the visits. Median follow-up time was 187 days after symptom onset for 6-month visit and 353 days after symptom onset for 12-month visit. The proportion of patients with at least one sequelae symptom decreased from 143 (73%) at 6 months to 99 (51%) at 12 months (p<0.01), the decrease was observed in all the symptoms studied in the patients. Breathlessness on exertion was the most commonly observed symptom which fell from 133 (68%) at 6 months to 82 (42%) at 12 months (0.001). The proportion of patients with fatigue or muscle weakness fell from 105 (54%) at 6 months to 70 (36%) at 12 months (<0.01). No significant difference in median 6MWD between 6 months and 12 months was observed.Conclusions: Most hospital survivors with COVID-19 had a good physical and functional recovery over time but some of the symptoms persisted at 12 months follow-up.