TRAJECTORY OF MODIFIED MEDICAL RESEARCH COUNCIL DYSPNEA RATINGS IN PATIENTS WITH COVID-19 DISCHARGED FOLLOWING A HOSPITALIZATION OR ED ENCOUNTER

Abstract

TYPE: Abstract TOPIC: Chest Infections PURPOSE: Prolonged dyspnea often follows COVID-19 infection, but little objective analysis of this symptom is available. Accordingly, we measured trajectory of dyspnea over time. METHODS: Following IRB approval, we surveyed patients by telephone twice following a hospital or emergency department discharge for COVID-19 between March and July, 2021. Dyspnea was rated using the MRC (0-4 range, higher scores indicating greater dyspnea). Predictor variables included age, sex, Charlson Comorbidity Index, race/ethnicity, socioeconomic status (low SES marker = Medicaid or no insurance), and a 10-variable acute COVID-19 severity score. RESULTS: Fifty-four patients were surveyed at 32 ± 10 days; 40 were contacted subsequently at 89 ± 25 days. In the latter subgroup, mean age was 53 ± 15 years, 50% were female, 40% had low SES, and 20% had Charlson > 2. MRC was 1.70 ± 1.38 at baseline and tended to decrease at follow-up: -0.28 ± 1.11, p = 0.12. In multivariate analysis with change in MRC as dependent variable, the above list as predictor variables, and time to the second survey as covariate, only comorbidity and SES significantly predicted change in dyspnea (mean ± SE, between-group comparison): Charlson > 2 vs. ≤ 2: 0.60 ± 0.36 vs. -0.39 ± 018, respectively, p = 0.02; presence vs. absence low SES: 0.50 ± 0.28 vs. -0.30 ± 0.24, respectively, p = 0.02. CONCLUSIONS: In this small sample, less baseline comorbidity and absence of the low SES marker predicted late improvement in MRC dyspnea after COVID-19 infection. CLINICAL IMPLICATIONS: Prolonged dyspnea post-COVID-19 may reflect treatment disparities and pre-existing comorbidity. DISCLOSURE: Nothing to declare. KEYWORD: COVID-19