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Minerva Medica 2021 Dec 03

DOI: 10.23736/S0026-4806.21.07594-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Long-lasting consequences of Coronavirus disease 19 pneumonia: a systematic review

Filippo PATRUCCO 1, Patrizia ZEPPEGNO 2, 3, Alessio BARICICH 4, 5 , Carla M. GRAMAGLIA 2, 3, Piero E. BALBO 1, Zeno FALASCHI 2, 6, Alessandro CARRIERO 2, 6, Daria CUNEO 4, 5, Mario PIRISI 2, 7, Mattia BELLAN 2, 7

1 Pneumology Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy; 2 Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy; 3 Psychiatry Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy; 4 Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy; 5 Physical and Rehabilitation Medicine, Ospedale Maggiore della Carità University Hospital, Novara, Italy; 6 Radiology Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy; 7 Internal Medicine Department, Ospedale Maggiore della Carità University Hospital, Novara, Italy


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INTRODUCTION: Coronavirus Disease 19 (Covid-19) is an infectious disease caused by the newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We have plenty of data about the clinical features of the disease's acute phase, while little is known about the long-term consequences on survivors.
EVIDENCE ACQUISITION: We aimed to review systematically emerging evidence about clinical and functional consequences of Covid-19 pneumonia months after hospital discharge.
EVIDENCE SYNTHESIS: Current evidence supports the idea that a high proportion of Covid-19 survivors complain of symptoms months after the acute illness phase, being fatigue and reduced tolerance to physical effort the most frequently reported symptom. The strongest association for these symptoms is with the female gender, while disease severity seems less relevant. Respiratory symptoms are associated with a decline in respiratory function and, conversely, seem to be more frequent in those who experienced a more severe acute pneumonia. Current evidence highlighted a persistent motor impairment which is, again, more prevalent among those survivors who experienced a more severe acute phase of the disease. Additionally, the persistence of symptoms is a primary determinant of mental health outcome, with anxiety, depression, sleep disturbances, and post-traumatic stress symptoms being commonly reported in Covid-19 survivors.
CONCLUSIONS: Current literature highlights the importance of a multidisciplinary approach to Coronavirus Disease 19 since the sequelae appear to involve different organs and systems. Given the pandemic outbreak's size, this is a critical public health issue: a better insight on this topic should inform clinical decisions about the modalities of follow-up for Covid-19 survivors.


KEY WORDS: COVID-19; Pandemics; SARS-CoV-2; Complications; Respiration disorders; Physical functional performance; Fatigue; Rehabilitation; Anxiety; Stress disorders post-traumatic

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