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Late assessment of physical, psychological and cognitive effects in a cohort of patients surviving COVID-19 hospitalization at a tertiary university hospital: a multidisciplinary approach


The COVID-19 pandemic originated a giant challenge for the health system inorder to handle the treatment of the acute phase of the disease. After few months of pandemic, it became clear that there was another enormous challenge, the follow-up and management of the frequent persistent median and long-term consequences of the COVID-19, which full magnitude its is far to be acknowledged. The post COVID-19 manifestations have been divided in those that appear up to 12 weeks after the disease (acute post COVID-19 syndrome - APCS or post-acute sequelae caused by SARS-coV-2 infection) or those that appear after this time (chronic post-COVID-19 syndrome or long term COVID). It is still unclear if they are the same or distinct diseases with different risk phenotypes. These sequalae are multifactorial, affecting the lungs, kidneys, heart, endocrine organs, central nervous system, muscle, gastrointestinal system, among other organs and systems. During the most critical phase of pandemic the Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP) was a central assistance center dedicated to the hospitalization of patients with moderate/severe COVID-19 in Sao Paulo, hospitalizing more than 8,000 patients. The present study aims to assess a cohort of 749 patients surviving hospitalization due to COVID-19 in HCFMUSP during 2020. Most of the patients had severe COVID-19 with hospitalization in intensive care units. Those 749 patients will be evaluated annually by a multidisciplinary health team for 4 years (the first evaluation wave, done after 6-11 months after discharge, was already completed). The assessment encompasses a complete physical and neurological exam, mental health and disability evaluation, quality of life and functional physical status, pulmonary function tests, evaluation of kidney, heart, endocrinological, reproductive, hematological function, thoracic image exams, neurological and olfactory tests. In addition to the individual health characteristics, this population will be mapped in its environment characteristics (green areas, pollution, house characteristics) and socioeconomical status. The goals of this research project are to evaluate the median/long term physical, psychological and cognitive consequences of moderate/severe COVID-19 patients through a multidisciplinary approach, to assess the incidence and risk factors for long term sequelae and to elaborate protocols of therapeutic interventions for treatment of the late manifestations of the disease, analyzing the potential reversibility/attenuation of the abnormalities detected in these patients. (AU)

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