Dynamic changes of functional fitness, antibodies to SARS-CoV-2 and immunological indicators within 1 year after discharge in Chinese health care workers with severe COVID-19: a cohort study

BMC Medicine

Jun Tong¹  Tengfei Chen²  Qingquan Liu²  Jiahong Xia³  Huangguo Xiong⁴  Xiongjing Cao⁴  Yupeng Zhang⁴  Lijuan Xiong⁴  Yunzhou Fan⁴  Gang Wang⁵  Yanzhao Zhang⁵  Mei Zhou⁶  Daquan Meng⁶  Xinliang He⁶  Yang Jin⁶  Fengwen Yang⁷  Liang Tang⁸  Qian Li⁸  Yu Hu⁸  Ming Huang⁹ 

[1] Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China;CCM, Medicine Bachelor Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China;Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, Hubei, China;Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China;Department of Rehabilitation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China;Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, Hubei, China;Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China;Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430022, Wuhan, Hubei, China;State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China;

关键词: Novel coronavirus;    COVID-19;    Antibody;    Cytokine;    Lymphocyte subsets;   

DOI  :  10.1186/s12916-021-02042-0

来源: Springer

【 摘 要 】

BackgroundFew studies had described the health consequences of patients with coronavirus disease 2019 (COVID-19) especially in those with severe infections after discharge from hospital. Moreover, no research had reported the health consequences in health care workers (HCWs) with COVID-19 after discharge. We aimed to investigate the health consequences in HCWs with severe COVID-19 after discharge from hospital in Hubei Province, China.MethodsWe conducted an ambidirectional cohort study in “Rehabilitation Care Project for Medical Staff Infected with COVID-19” in China. The participants were asked to complete three physical examinations (including the tests of functional fitness, antibodies to SARS-CoV-2 and immunological indicators) at 153.4 (143.3, 164.8), 244.3 (232.4, 259.1), and 329.4 (319.4, 339.3) days after discharge, respectively. Mann-Whitney U test, Kruskal-Wallis test, t test, one-way ANOVA, χ2, and Fisher’s exact test were used to assess the variance between two or more groups where appropriate.ResultsOf 333 HCWs with severe COVID-19, the HCWs’ median age was 36.0 (31.0, 43.0) years, 257 (77%) were female, and 191 (57%) were nurses. Our research found that 70.4% (114/162), 48.9% (67/137), and 29.6% (37/125) of the HCWs with severe COVID-19 were considered to have not recovered their functional fitness in the first, second, and third functional fitness tests, respectively. The HCWs showed improvement in muscle strength, flexibility, and agility/dynamic balance after discharge in follow-up visits. The seropositivity of IgM (17.0% vs. 6.6%) and median titres of IgM (3.0 vs. 1.4) and IgG (60.3 vs. 45.3) in the third physical examination was higher than that in the first physical examination. In the third physical examination, there still were 42.1% and 45.9% of the HCWs had elevated levels of IL-6 and TNF-α, and 11.9% and 6.3% of the HCWs had decreased relative numbers of CD3+ T cells and CD4+ T cells.ConclusionThe HCWs with severe COVID-19 showed improvement in functional fitness within 1 year after discharge, active intervention should be applied to help their recovery if necessary. It is of vital significance to continue monitoring the functional fitness, antibodies to SARS-CoV-2 and immunological indicators after 1 year of discharge from hospital in HCWs with severe COVID-19.

【 授权许可】

CC BY