Systematic long COVID symptoms assessment in hypertensive and non-hypertensive individuals during the 12-months follow-up after hospital discharge

Abstract

Objective: To study the impact of hypertension on the dynamics of physical, emotional and cognitive symptoms during the 12-months follow-up after hospitalization for COVID-19. Design and method: 212 patients hospitalized for COVID-19 (50% hypertensive, 53% female, mean age 53,4±13,6 years) underwent comprehensive questionnaire survey evaluating physical (CAT, CCQ and mMRC dyspnea scales for respiratory and EFTER-COVID for other related symptoms), emotional (HADS) and cognitive well-being (Memory, Thinking and Communication subscale of SBQ-LC questionnaire, MTC-SBQ-LC) that was performed pre-discharge and repeated after 1, 3, and 12 months. Results: Despite being older (57,8±11,8 vs 50,7±13,9, p<0,001) and having higher BMI (31,7±5,3 vs 27,4±4,4 kg/m2, p<0,001), hypertensive patrticipants had similar baseline summary scores of symptoms severity but slightly higher mMRC dyspnea score (2,7±1,1 vs 2,3±1,1, p = 0,023), and no significant difference in trends of summary scores have been detected by ANOVA (see graphic abstract). Non-hypertensive subjects had worse baseline limitation of everyday activity, cough and sputum production by respective CAT and CCQ sections that were characterized by better dynamics during follow-up. The residual level of respiratory-related symptoms at 12 months was higher in hypertensive cohort (CAT score 8,1±5,1 vs 5,8±5,0, p = 0,003, CCQ score 7,5±6,1 vs 4,5±5,1, p<0,001, mMRC dyspnea score 1,57±0,63 vs 1,27±0,54, p<0,001), most likely due to more frequent concomitant obesity and diastolic dysfunction. The most striking data was obtained in the MTC-SBQ-LC: yonger and healthier non-hypertensive participants displayed similar trends of most cognitive symptoms to the hypertensive cohort, but had persistently worse brain fog, difficulties in understanding others’ speech, planning, concentrating, and word-finding, that resulted in significantly higher summary score at 12 months after discharge (1,71±2,36 vs 0,96±1,30, p = 0,010). No differences were detected in anxiety and depression levels as assessed by HADS. Conclusions: Hypertensive patients that had been hospitalized for COVID-19 displayed similar trends of resolving physical, emotional and cognitive symptoms throughout the 12-month follow-up but had higher levels of residual respiratory-related symptoms and dyspnoea compared to the non-hypertensive participants, whereas the latter were characterized by significantly higher level of cognitive dysfunction as assessed by the dedicated SBQ-LC subscale.