Long-term sequelae are highly prevalent one year after hospitalization for severe COVID-19

Sci Rep. 2021 Nov 22;11(1):22666. doi: 10.1038/s41598-021-01215-4.


Many coronavirus disease 2019 (Covid-19) survivors show symptoms months after acute illness. The aim of this work is to describe the clinical evolution of Covid-19, one year after discharge. We performed a prospective cohort study on 238 patients previously hospitalized for Covid-19 pneumonia in 2020 who already underwent clinical follow-up 4 months post-Covid-19. 200 consented to participate to a 12-months clinical assessment, including: pulmonary function tests with diffusing lung capacity for carbon monoxide (DLCO); post-traumatic stress (PTS) symptoms evaluation by the Impact of Event Scale (IES); motor function evaluation (by Short Physical Performance Battery and 2 min walking test); chest Computed Tomography (CT). After 366 [363-369] days, 79 patients (39.5%) reported at least one symptom. A DLCO < 80% was observed in 96 patients (49.0%). Severe DLCO impairment (< 60%) was reported in 20 patients (10.2%), related to extent of CT scan abnormalities. Some degree of motor impairment was observed in 25.8% of subjects. 37/200 patients (18.5%) showed moderate-to-severe PTS symptoms. In the time elapsed from 4 to 12 months after hospital discharge, motor function improves, while respiratory function does not, being accompanied by evidence of lung structural damage. Symptoms remain highly prevalent one year after acute illness.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / diagnostic imaging
  • COVID-19 / epidemiology
  • Carbon Monoxide / metabolism
  • Female
  • Hospitalization*
  • Humans
  • Italy / epidemiology
  • Logistic Models
  • Male
  • Mental Health
  • Middle Aged
  • Motor Activity
  • Patient Acuity
  • Patient Discharge
  • Post-Acute COVID-19 Syndrome
  • Prevalence
  • Prospective Studies
  • Pulmonary Diffusing Capacity
  • Respiratory Function Tests
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology
  • Survivors
  • Tomography, X-Ray Computed
  • Walk Test


  • Carbon Monoxide