J Korean Med Sci.  2024 Jan;39(2):e23. 10.3346/jkms.2024.39.e23.

Prognostic Factors for Predicting Post-COVID-19 Condition in Patients With COVID-19 in an Outpatient Setting

• Choi MG
• Joo YW
• Kim MH
• Park S
• Shin YY
• Chun EM

• KMID: 2550800
• DOI: http://doi.org/10.3346/jkms.2024.39.e23

Abstract

Background
Although data on post-coronavirus disease 2019 (COVID-19) conditions are extensive, the prognostic factors affecting symptom duration in non-hospitalized patients with COVID-19 are currently not well known. We aimed to investigate the various prognostic factors affecting symptom duration among outpatients with COVID-19.
Methods
Data were analyzed from 257 patients who were diagnosed with mild COVID-19 and visited the ‘post-COVID-19 outpatient clinic’ between April and December 2022 after a mandatory isolation period. The symptom duration was measured from diagnosis to symptom resolution. Laboratory and pulmonary function test results from their first visit were collected.
Results
The mean age of patients was 55.7 years, and the median symptom duration was 57 days. The development of post-COVID-19 conditions (> 12 weeks) were significantly correlated with not using antiviral drugs, leukocytosis (white blood cell > 10,000/µL), lower 25(OH)D 3 levels, forced vital capacity (FVC) < 90% predicted, and presence of dyspnea and anxiety/depression. Additionally, in multivariable Cox regression analysis, not using antiviral drugs, lower 25(OH)D 3 levels, and having dyspnea were poor prognostic factors for longer symptom duration. Particularly, vitamin D deficiency (< 20 ng/mL) and not using antivirals during the acute phase were independent poor prognostic factors for both post-COVID-19 condition and longer symptom duration.
Conclusion
The non-use of antivirals, lower 25(OH)D 3 levels, leukocytosis, FVC < 90% predicted, and the presence of dyspnea and anxiety/depression symptoms could be useful prognostic factors for predicting post-COVID-19 condition in outpatients with COVID-19. We suggest that the use of antiviral agents during the acute phase and vitamin D supplements might help reduce COVID-19 symptom duration.

Keyword

COVID-19; Post-COVID-19 Condition; Prognostic Factors

Figure

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  Fig. 1 Flowchart of the study population.OPD = outpatient department, COVID-19 = coronavirus disease 2019.

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  Fig. 2 Kaplan-Meier curves for symptom duration according to Vit D deficiency and use of antiviral agent. (A) Vit D deficiency. (B) Use of antiviral agent.Vit D = vitamin D.

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