Análise sintomatológica longitudinal de indivíduos sobreviventes da COVID-19 e pacientes com Síndrome Pós-COVID

Abstract

Currently, we are facing COVID-19, caused by infection by SARS-CoV-2 virus. Infected individuals can be classified as asymptomatic or present a variety of symptoms, ranging from mild symptoms to severe cases of fatal sepsis. The main symptoms are respiratory, although other organs may also be affected. Evidence has been collected about the post-COVID condition, where individuals who have recovered from COVID-19 experience persistent or new symptoms that last for weeks or months, significantly compromising their quality of life. Considering the large percentage of symptomatic COVID-19 survivors, Remote Patient Monitoring (RPM) has expanded as a mechanism to assess and monitor patients at home. The objective of the present study was to analyze the symptomatic changes throughout the recovery process of COVID-19 survivors and Post-COVID Syndrome patients through home monitoring of the intensity of symptoms such as shortness of breath, fatigue, fever, cough, expectoration, headache, sore throat, body pain, diarrhea, other symptoms, and blood pressure (BP). Additionally, the study aimed to associate the symptomatic findings with the disease's pathophysiology. The RPM was conducted for 15 days, once per day, through an app SintomV2, created in our laboratory specifically for this study and includes a list of COVID-19-related symptoms. This is an analytical, descriptive longitudinal study in which 133 individuals aged 20 to 78 years were analyzed: 40 in the mild group (GL), 40 in the hospital discharge group without invasive mechanical ventilation (IMV) (GSVM), 13 in the hospital discharge group with IMV (GCVM), and 40 in the reinfected group (GR). Fever, expectoration, sore throat, and diarrhea had the lowest mean intensities among the observed symptoms. In contrast, shortness of breath, fatigue, cough, headache, body pain, and other symptoms had the highest mean intensities. The GSVM group had the highest averages in six symptoms (fever, expectoration, diarrhea, cough, shortness of breath, and headache) (p<0.01), followed by the GCVM group, with the highest averages in four symptoms (sore throat, fatigue, body pain, and other symptoms) (p<0.05). Overall, fatigue was the symptom with the highest intensity. Memory lapse was the other symptoms most prevalent. The GCVM and GSVM groups had the highest intensities across all symptoms in general (p<0.05). Despite the fluctuations in symptom intensity over time, a trend of gradual decrease was observed. However, hospitalized patients showed higher intensity and prevalence of the symptoms. BP was higher in the GL group compared to the GR group, although values remained within normal ranges (p<0.0001). Therefore, we suggest that the results of this study are consistent with the pathophysiology of COVID-19 and Post-COVID and can be described and analyzed through RPM.