Clinical and Functional Outcomes of COVID-19 Survivors After Hospitalization

Arnengsih Nazir, Salsabila S S Putri, Muhammad Hasan Bashari


Coronavirus disease 2019 (COVID-19) causes various clinical manifestations during acute infection and at the post-acute phase with persistent symptoms called long COVID. It occurs in mild and moderate to severe cases which require hospitalization. In patients needing hospitalization, especially intensive care unit admission, the risk of long COVID increases. Many hospitalized patients exhibited more symptoms in 60 days after the illness than non-hospitalized patients. This review aimed to identify the clinical and functional outcomes in COVID-19 survivors after hospitalization. The articles in the PubMed database published in 2019-2021 were reviewed and found 20 be eligible. The clinical outcomes were the appearance or persistence of general and multi-organ symptoms, nutritional disorders, and decreased lung function. The functional outcomes found were decreased muscle strength, physical, psychological, and cognitive functions, increased disability and dependencies, as well as decreased vocational status and quality of life. The incidence of each outcome could not be determined due to the variety of methods used to examine and present outcomes. To conclude, COVID-19 causes long-term clinical and functional outcomes that need to be identified to prevent and manage long-term physical and functional disorders.


COVID-19; hospitalization; post-acute COVID-19 syndrome; quality of life; survivor

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  1. World Health Organization. Clinical management of COVID-19. Geneva: World Health Organization; 2021.

  2. Kompaniyets L, Pennington AF, Goodman AB, et al. Underlying medical conditions and severe illness among 540,667 adults hospitalized with COVID-19, March 2020–March 2021. Prev Chronic Dis. 2021; 18: E66.

  3. National Center of Immunization and Respiratory Disease United States. Assessing risk factors for severe COVID-19 illness. Atlanta, GA: Centers for Disease Control and Prevention; 2020.

  4. Shah W, Hillman T, Playford ED, et al. Managing the long term effects of covid-19: Summary of NICE, SIGN, and RCGP rapid guideline. BMJ. 2021; 372: n136.

  5. Hayes LD, Ingram J, Sculthorpe NF. More than 100 persistent symptoms of SARS-CoV-2 (Long COVID): A scoping review. Front Med (Lausanne). 2021; 8: 750378.

  6. Menges D, Ballouz T, Anagnostopoulos A, et al. Burden of post-COVID-19 syndrome and implications for healthcare service planning: A population-based cohort study. PloS One. 2021; 16 (7): e0254523.

  7. National Center of Immunization and Respiratory Disease United States. Long COVID or Post-COVID conditions. Atlanta, GA: Centers for Disease Control and Prevention; 2021.

  8. Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V, et al. Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: A systematic review and meta-analysis. Eur J Intern Med. 2021; 92: 55-70.

  9. Martillo MA, Dangayach NS, Tabacof L, et al. Post intensive care syndrome in survivors of critical illness related to coronavirus disease 2019: Cohort study from a New York City critical care recovery clinic. Crit Care Med. 2021; 49 (9): 1427-1438.

  10. Hall J, Myall K, Lam JL, et al. Identifying patients at risk of post-discharge complications related to COVID-19 infection. Thorax. 2021;76 (4): 408-11.

  11. D'Cruz RF, Waller MD, Perrin F, et al. Chest radiography is a poor predictor of respiratory symptoms and functional impairment in survivors of severe COVID-19 pneumonia. ERJ Open Res. 2021; 7(1): 00655-2020.

  12. Cao J, Zheng X, Wei W, et al. Three-month outcomes of recovered COVID-19 patients: Prospective observational study. Ther Adv Respir Dis. 2021; 15: 17534666211009410.

  13. Monti G, Leggieri C, Fominskiy E, et al. Two‐months quality of life of COVID‐19 invasively ventilated survivors; an Italian single‐center study. Acta Anaesthesiol Scand. 2021; 65 (7): 912-920.

  14. Strumiliene E, Zeleckiene I, Bliudzius R, et al. Follow-up analysis of pulmonary function, exercise capacity, radiological changes, and quality of life two months after recovery from SARS-CoV-2 pneumonia. Medicina (Kaunas). 2021; 57 (6): 568.

  15. Schandl A, Hedman A, Lyngå P, et al. Long‐term consequences in critically ill COVID‐19 patients: A prospective cohort study. Acta Anaesthesiol Scand. 2021; 65 (9): 1285-1292.

  16. Van Gassel RJ, Bels J, Remij L, et al. Functional outcomes and their association with physical performance in mechanically ventilated coronavirus disease 2019 survivors at 3 months following hospital discharge: A cohort study. Crit Care Med. 2021; 49 (10): 1726-1738.

  17. González J, Benítez ID, Carmona P, et al. Pulmonary function and radiologic features in survivors of critical COVID-19: A 3-month prospective cohort. Chest. 2021; 160 (1): 187-198.

  18. Todt BC, Szlejf C, Duim E, et al. Clinical outcomes and quality of life of COVID-19 survivors: A follow-up of 3 months post hospital discharge. Respir Med. 2021; 184: 106453.

  19. De Lorenzo R, Cinel E, Cilla M, et al. Physical and psychological sequelae at three months after acute illness in COVID-19 survivors.Panminerva Med. 2021; 1.

  20. Rousseau A-F, Minguet P, Colson C, et al. Post-intensive care syndrome after a critical COVID-19: Cohort study from a Belgian follow-up clinic. Ann Intensive Care. 2021; 11 (1): 118-126.

  21. Sigfrid L, Drake TM, Pauley E, et al. Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol. Lancet Reg Health Eur. 2021; 8: 100186.

  22. Latronico N, Peli E, Calza S, et al. Physical, cognitive and mental health outcomes in 1-year survivors of COVID-19-associated ARDS.Thorax. 2022; 77 (3): 300-303.

  23. Boari GE, Bonetti S, Braglia-Orlandini F, et al. Short-term consequences of SARS-CoV-2-related pneumonia: A follow up study. High Blood Press Cardiovasc Prev. 2021; 28 (4): 373-81.

  24. Bellan M, Soddu D, Balbo PE, et al. Respiratory and psychophysical sequelae among patients with COVID-19 four months after hospital discharge. JAMA Netw Open. 2021; 4 (1): e2036142-e.

  25. Guler SA, Ebner L, Aubry-Beigelman C, et al. Pulmonary function and radiological features 4 months after COVID-19: First results from the national prospective observational Swiss COVID-19 lung study. Eur Respir J. 2021; 57 (4): 2003690.

  26. Van Veenendaal N, van der Meulen IC, Onrust M, et al. Six-month outcomes in COVID-19 ICU patients and their family members: A prospective cohort study. Healthcare (Basel). 2021; 9 (7): 865.

  27. Lombardo MDM, Foppiani A, Peretti GM, et al. Long-term coronavirus disease 2019 complications in inpatients and outpatients: A one-year follow-up cohort study. Open Forum Infect Dis. 2021; 8 (8): ofab384.

  28.Bertolucci F, Sagliocco L, Tolaini M, et al. Comprehensive rehabilitation treatment for sub-acute COVID-19 patients: An observational study. Eur J Phys Rehabil Med. 2021; 57 (2): 208-215.

  29. Proal AD, VanElzakker MB. Long COVID or post-acute sequelae of COVID-19 (PASC): An overview of biological factors that may contribute to persistent symptoms. Front Microbiol. 2021; 12:698169.

  30. Ortona E, Malorni W. Long COVID: To investigate immunological mechanisms and sex/gender related aspects as fundamental steps for tailored therapy. Eur Respir J. 2022; 59 (2): 2102245.

  31. Neerukonda SN, Katneni U. A review on SARS-CoV-2 virology, pathophysiology, animal models, and anti-viral interventions. Pathogens. 2020; 9 (6): 426.

  32. Robbins-Juarez SY, Qian L, King KL, et al. Outcomes for patients with COVID-19 and acute kidney injury: A systematic review and meta-analysis. Kidney Int Rep. 2020; 5 (8): 1149-1160.

  33. Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021; 27 (4): 601-615.

  34. Di Filippo L, De Lorenzo R, D'Amico M, et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort study. Clin Nutr. 2021; 40 (4): 2420-2426.

  35. Quilliot D, Gérard M, Bonsack O, et al. Impact of severe SARS-CoV-2 infection on nutritional status and subjective functional loss in a prospective cohort of COVID-19 survivors. BMJ Open. 2021; 11 (7): e048948.

  36. Del Brutto OH, Mera RM, Pérez P, et al. Hand grip strength before and after SARS‐CoV‐2 infection in community‐dwelling older adults. J Am Geriatr Soc. 2021; 69 (10): 2722-2731.

  37. Puchner B, Sahanic S, Kirchmair R, et al. Beneficial effects of multi-disciplinary rehabilitation in postacute COVID-19: An observational cohort study. Eur J Phys Rehabil Med. 2021; 57 (2): 189-198.

  38. Wong A, López-Romero S, Figueroa-Hurtado E, et al. Predictors of reduced 6-minute walk distance after COVID-19: A cohort study in Mexico. Pulmonology. 2021; 27 (6): 563-565.

  39. Penninx BW. Psychiatric symptoms and cognitive impairment in "Long COVID": The relevance of immunopsychiatry. World Psychiatry. 2021; 20 (3): 357-358. DOI: 10.1002/wps.20913

  40. Hosey MM, Needham DM. Survivorship after COVID-19 ICU stay. Nat Rev Dis Primers. 2020; 6 (1): 60.



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