. 2021 Sep 21;1-10.
doi: 10.1159/000518854. Online ahead of print.
Fatigue and Dyspnoea as Main Persistent Post-COVID-19 Symptoms in Previously Hospitalized Patients: Related Functional Limitations and Disability

César Fernández-de-Las-Peñas 1 , Domingo Palacios-Ceña 1 , Víctor Gómez-Mayordomo 2 , María Palacios-Ceña 1 , Jorge Rodríguez-Jiménez 1 , Ana I de-la-Llave-Rincón 1 , María Velasco-Arribas 3 4 , Stella Fuensalida-Novo 1 , Silvia Ambite-Quesada 1 , Carlos Guijarro 3 4 , María L Cuadrado 2 5 , Lidiane L Florencio 1 , José A Arias-Navalón 6 , Ricardo Ortega-Santiago 1 , Carlos M Elvira-Martínez 2 , Luis J Molina-Trigueros 1 7 , Juan Torres-Macho 5 8 , Tomas Sebastián-Viana 7 , María Gabriela Canto-Diez 5 8 , Margarita Cigarán-Méndez 9 , Valentín Hernández-Barrera 10 , Lars Arendt-Nielsen 11

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Background: Multicentre studies focussing on specific long-term post-COVID-19 symptoms are scarce.
Objective: The aim of this study was to determine the levels of fatigue and dyspnoea, repercussions on daily life activities, and risk factors associated with fatigue or dyspnoea in COVID-19 survivors at long term after hospital discharge.
Methods: Age, gender, height, weight, symptoms at hospitalization, pre-existing medical comorbidity, intensive care unit admission, and the presence of cardio-respiratory symptoms developed after severe acute respiratory syndrome coronavirus 2 infection were collected from patients who recovered from COVID-19 at 4 hospitals in Madrid (Spain) from March 1 to May 31, 2020 (first COVID-19 wave). The Functional Impairment Checklist was used for evaluating fatigue/dyspnoea levels and functional limitations.
Results: A total of 1,142 patients (48% women, age: 61, standard deviation [SD]: 17 years) were assessed 7.0 months (SD 0.6) after hospitalization. Fatigue was present in 61% patients, dyspnoea with activity in 55%, and dyspnoea at rest in 23.5%. Only 355 (31.1%) patients did not exhibit fatigue and/or dyspnoea 7 months after hospitalization. Forty-five per cent reported functional limitations with daily living activities. Risk factors associated with fatigue and dyspnoea included female gender, number of pre-existing comorbidities, and number of symptoms at hospitalization. The number of days at hospital was a risk factor just for dyspnoea.
Conclusions: Fatigue and/or dyspnoea were present in 70% of hospitalized COVID-19 survivors 7 months after discharge. In addition, 45% patients exhibited limitations on daily living activities. Being female, higher number of pre-existing medical comorbidities and number of symptoms at hospitalization were risk factors associated to fatigue/dyspnoea in COVID-19 survivors 7 months after hospitalization.

Keywords: COVID-19; Dyspnoea; Fatigue; Function; Risk factors.