CHARACTERIZATION OF BASELINE SYMPTOMS AND FUNCTIONAL IMPAIRMENTS IN A LARGE COHORT OF OUTPATIENTS ATTENDING A LONG COVID REHABILITATION CLINIC IN THE UNITED KINGDOM

J Rehabil Med Clin Commun. 2024 Oct 30:7:39984. doi: 10.2340/jrm-cc.v7.39984. eCollection 2024.

Abstract

Objective: In response to the high prevalence and morbidity associated with long COVID (LC), outpatient rehabilitation programmes were created across jurisdictions. We aimed to characterize baseline symptoms and impairments of patients attending outpatient LC rehabilitation.

Design: This study was a retrospective quality-improvement analysis.

Subjects/patients: Patients attending outpatient LC rehabilitation at the Oxfordshire Post-Covid Service.

Methods: Data included age/sex and 6 questionnaires performed at baseline: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Dyspnoea-12 (D12), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Assessment-7 (GAD-7), Visual Analogue Scale (VAS) of self-rated health, and the Work And Social Adjustment Scale (WSAS). All scores were dichotomized (indicating presence/absence of clinically significant pathology). Potential differences between age (</≥ 50 years) and sex were assessed using χ2 tests.

Results: A total of 422 patients were included (mean/standard deviation [SD] age = 47.1/13.2;132/31.3% male). A total of 76% had significant fatigue (FACIT-F), 69% had breathlessness (D12), 55% had depression (PHQ-9), 34% had anxiety (GAD-7), 41% self-reported poor health (VAS), and 57% had work/social life dysfunction (WSAS). D12 scores differed between age groups (older > younger, χ2 = 3.19/p = 0.048), with no differences observed on other scales.

Conclusion: In this preliminary study, a high proportion of LC outpatients had significant impairments across domains. The findings of this study reaffirm the need for high-quality, multidisciplinary LC rehabilitation, and may be used to help build a standardized set of outcome measures moving forward.

Keywords: post-acute COVID-19 syndrome; rehabilitation; retrospective studies.

Plain language summary

Long COVID (aka post-acute COVID-19 syndrome) occurs when people experience long-term, debilitating symptoms for several weeks to months after the initial infection from SARS-CoV-2. To try to help patients recover, health systems around the world have started multidisciplinary long COVID rehabilitation clinics. However, as these clinics are new, they have not yet been adequately studied. In this study, we analysed over 400 patients who attended the Oxfordshire Post-Covid Service. At their first appointment, they were given 6 questionnaires that aimed to quantify symptoms in the following areas: fatigue, breathlessness, depression, anxiety, self-rated overall health, and work/social life dysfunction. We found that long COVID patients attending this clinic had significant symptoms across all the domains assessed on the 6 questionnaires. Therefore, our work reinforces the need for long COVID rehabilitation programmes, and suggests these questionnaires could be implemented at long COVID rehabilitation clinics and research centres elsewhere.