Background Long-term outcome data of COVID-19 survivors are needed to assess additional care needs. Studies focus mainly on the first wave (W1), whilst data on patient outcome during the second wave (W2) are scarce.
Objective We aimed to identify differences in outcomes between W1 and W2, and potential implications of corticosteroid (CS) use.
Methods We included 306 adults (W1=126, W2=180) with moderate or severe COVID-19 admitted at Ghent University Hospital during W1 and W2 in a prospective observational study. Patients underwent clinical, radiological and functional assessment with Modified Medical Research Council (mMRC) Dyspnoea Scale, CT scan, 6-minute walking test, pulmonary function tests (PFT), muscle strength and Hospital Anxiety and Depression Scale at 3 months after discharge.
Results Significantly more patients reported a mMRC score ?2 in W2. D_LCO was more reduced in W2 compared with W1 (35% vs. 21%, p=0.006). A lower D_LCO correlated significantly with pre-existing lung disease, CS use, female sex, and longer hospital stay. No difference in CT severity score was seen. Quadriceps strength was <70% predicted in up to 80% of patients without a significant difference between W1 and W2. The use of CS predicted a worse hand grip strength (HGS). A significantly higher anxiety score (?8) was found in the severe group of W2 (32% vs. 11% in W1) with depression scale results representing the same trend.
Conclusion Overall, patients in W2 suffered more persistent symptoms and impaired PFT at follow-up. However, for both severe COVID groups, outcomes were comparable except for anxiety score. In addition, CS use was associated with a lower D_LCO and HGS.