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Cited by 110Long-Term Effects of COVID-19COVID-19 Clinical Research StudiesMedical Practices and Rehabilitation

Post-COVID-19 assessment in a specialist clinical service: a 12-month, single-centre, prospective study in 1325 individuals

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Heightman, Melissa, Prashar, Jai, Hillman, Toby E, Marks, Michael, Livingston, Rebecca, Ridsdale, Heidi A, Roy, Kay, Bell, Robert +19 more·2021·BMJ Open Respiratory Research
DOI 10.1136/bmjresp-2021-001041PMC PMC8587466

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Abstract

Introduction: Post-COVID-19 complications require simultaneous characterisation and management to plan policy and health system responses. We describe the 12-month experience of the first UK dedicated post-COVID-19 clinical service to include hospitalised and non-hospitalised patients. Methods: In a single-centre, observational analysis, we report the demographics, symptoms, comorbidities, investigations, treatments, functional recovery, specialist referral and rehabilitation of 1325 individuals assessed at the University College London Hospitals post-COVID-19 service between April 2020 and April 2021, comparing by referral route: posthospitalised (PH), non-hospitalised (NH) and post emergency department (PED). Symptoms associated with poor recovery or inability to return to work full time were assessed using multivariable logistic regression. Results: 1325 individuals were assessed (PH: 547, 41.3%; PED: 212, 16%; NH: 566, 42.7%). Compared with the PH and PED groups, the NH group were younger (median 44.6 (35.6–52.8) years vs 58.3 (47.0–67.7) years and 48.5 (39.4–55.7) years), more likely to be female (68.2%, 43.0% and 59.9%), less likely to be of ethnic minority (30.9%, 52.7% and 41.0%) or seen later after symptom onset (median (IQR): 194 (118–298) days, 69 (51–111) days and 76 (55–128) days; all p<0.0001). All groups had similar rates of onward specialist referral (NH 18.7%, PH 16.1% and PED 18.9%, p=0.452) and were more likely to require support for breathlessness (23.7%, 5.5% and 15.1%, p<0.001) and fatigue (17.8%, 4.8% and 8.0%, p<0.001). Hospitalised patients had higher rates of pulmonary emboli, persistent lung interstitial abnormalities and other organ impairment. 716 (54.0%) individuals reported <75% optimal health (median 70%, IQR 55%–85%). Less than half of employed individuals could return to work full time at first assessment. Conclusion: Post-COVID-19 symptoms were significant in PH and NH patients, with significant ongoing healthcare needs and utilisation. Trials of interventions and patient-centred pathways for diagnostic and treatment approaches are urgently required.

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Authors
Heightman, M., Prashar, J., Hillman, T. E., Marks, M., Livingston, R., Ridsdale, H. A., Roy, K., Bell, R., Zandi, M., McNamara, P., Chauhan, A., Denneny, E., Astin, R., Purcell, H., Attree, E., Hishmeh, L., Prescott, G., Evans, R., Mehta, P., Brennan, E., Brown, J. S., Porter, J., Logan, S., Wall, E., Dehbi, H.-M., Cone, S., & Banerjee, A.
Affiliations
  • University College London Hospitals NHS Foundation Trust (GB)
  • Central and North West London NHS Foundation Trust (GB)
  • University College London Hospitals NHS Foundation Trust, London, UK
  • UKDoctors#Longcovid, London, UK
  • Long COVID SOS, Oxford, UK
  • University of Lancashire (GB)
  • University College London (GB)
Corresponding author
Banerjee, Amitava
ORCID
Venue
BMJ Open Respiratory Research
Publisher
BMJ
Published
2021-11
Volume
8
Issue
1
Pages
e001041
ISSN
2052-4439 (ISSN-L)
DOI
10.1136/bmjresp-2021-001041
PMC
PMC8587466
OpenAlex
W3212611507
Cited by
110
References
5
Citations by year
2026: 5 · 2025: 17 · 2024: 20 · 2023: 29 · 2022: 35 · 2021: 4
FWCI
10.53
Type
journal article
Language
en
Update notices
correction (2022-01-21)
Open access
Licence
Locations
  • BMJ Open Respiratory Research (publishedVersion, cc-by-nc)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • CLOK (University of Central Lancashire) (acceptedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • ULC/UCLH Biomedical Research Centre (N/A)
  • National Institute for Health Research (LT2-0043)
Topics
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords
long COVID, functional recovery, specialist referral, rehabilitation, return to work, dyspnea, fatigue, pulmonary embolism, comorbidities, referral timing, emergency department referral
MeSH terms
COVID-19, SARS-CoV-2, Delivery of Health Care, Ethnicity, Female, Humans, Male, Minority Groups, Prospective Studies

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