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Falsetti L, Zaccone V, Santoro L, Santini S, Guerrieri E, Giuliani L, Viticchi G, Cataldi S, Gasbarrini A, Landi F, Santoliquido A, Moroncini G. The Relationship between Post-COVID Syndrome and the Burden of Comorbidities Assessed Using the Charlson Comorbidity Index. Medicina (Kaunas) 2023; 59:1583. [PMID: 37763702 PMCID: PMC10533175 DOI: 10.3390/medicina59091583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/22/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023]
Abstract
Introduction: The post-COVID-19 syndrome is a clinical entity characterized by the manifestation of signs and symptoms that develop after the acute phase of COVID-19, which persist for a duration of more than 12 weeks and are not explained by any alternative diagnosis. It has been observed that individuals with pre-existing chronic diseases, including cardiovascular and pulmonary diseases, are at a greater risk of developing post-COVID-19 syndrome. The Charlson Comorbidity Index (CCI) is a useful tool employed to evaluate the burden of comorbidities and predict the prognosis of patients with post-COVID-19 syndrome. The present study aims to assess whether the burden of comorbidities, evaluated using the CCI, correlates with post-COVID-19 syndrome. Materials and Methods: Between 21 April 2020 and 15 May 2023, we enrolled all consecutive outpatients with previous COVID-19 admissions to a post-acute day-hospital service three months after a negative SARS-CoV-2 molecular test. We assessed age, sex, BMI, acute COVID-19 and post-COVID-19 signs, and symptoms and calculated CCI according to its current definition. Post-COVID-19 syndrome was defined as the persistence of at least one sign or symptom lasting more than 12 weeks after COVID-19 resolution and not explained by an alternative diagnosis. The relationship between post-COVID-19 and CCI was explored first with the chi-squared test, then with different binary logistic regression models. We considered significant values of p lower than 0.05. Results: We obtained a cohort of 3636 patients and observed a significant association between the number of post-COVID-19 symptoms and CCI. Patients developing post-COVID-19 were more commonly affected by a greater burden of comorbidities. Patients with at least one CCI point had an increased risk of post-COVID-19 syndrome (OR:2.961; 95%CI: 2.269-3.863; p < 0.0001), which increased further for CCI ≥ 4 (OR:6.062; 95%CI: 3.163-11.618; p < 0.0001). Conclusions: Patients affected by post-COVID-19 show a greater clinical complexity and a larger burden of comorbidities, synthesized by a higher CCI; moreover, a higher CCI seems to correlate with an increasing post-COVID-19 risk, being the presence of ≥1 or ≥4 CCI points associated with a 3-fold and 6-fold increased risk of post-COVID-19 syndrome, respectively.
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Affiliation(s)
- Lorenzo Falsetti
- Clinica Medica, Department of Clinical and Molecular Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.F.); (G.M.)
| | - Vincenzo Zaccone
- Internal and Subintensive Medicine, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy;
| | - Luca Santoro
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
| | - Silvia Santini
- Emergency Medicine Residency Program, Marche Polytechnic University, 60126 Ancona, Italy; (S.S.); (E.G.); (L.G.)
| | - Emanuele Guerrieri
- Emergency Medicine Residency Program, Marche Polytechnic University, 60126 Ancona, Italy; (S.S.); (E.G.); (L.G.)
| | - Luca Giuliani
- Emergency Medicine Residency Program, Marche Polytechnic University, 60126 Ancona, Italy; (S.S.); (E.G.); (L.G.)
| | - Giovanna Viticchi
- Clinica Neurologica, Department of Medical and Surgical Sciences, Marche Polytechnic University, 60126 Ancona, Italy;
| | - Serena Cataldi
- Department of Pediatrics, Marche Polytechnic University, 60126 Ancona, Italy;
| | - Antonio Gasbarrini
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Francesco Landi
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Geriatrics Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Angelo Santoliquido
- Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy;
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Gianluca Moroncini
- Clinica Medica, Department of Clinical and Molecular Sciences, Marche Polytechnic University, 60126 Ancona, Italy; (L.F.); (G.M.)
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