35. Health-related quality of life in COVID-19 survivors after 12 months, a prospective cohort study

Abstract Background The long-term effects of COVID-19 are still unknown. This study aims to assess the impact of COVID-19 among survivors after one year. Methods All confirmed COVID-19 cases who presented at OLVG hospital in Amsterdam during the first wave of the COVID-19 pandemic were invited to participate in our prospective observational cohort study. The participants were divided into three subgroups: patients not admitted, admitted to the general ward and admitted to the ICU. Questionnaires were sent at 3, 6 and 12 months after presentation. We used the Research and Development – 36-item health survey, the Hospital Anxiety and Depression Scale and the PTSS Checklist for DSM-5. We compared the RAND-36 scores at the timepoints with a Dutch healthy control population in 2020 and between the three subgroups using the Kruskal-Wallis test and the Mann-Whitney U test. Results Of the 466 confirmed cases, 75 patients died of COVID-19, 64 patients were lost to follow up and 12 patients were excluded because they were unable to complete the questionnaires due to mental illness or cognitive impairment, they moved back to their home country or refused to participate. Of the remaining 315 patients, 182 (57.8%) completed the questionnaires at 3 months. Subsequently, 163 patients provided informed consent for follow up. At 6 and 12 months, 98 (60.1%) and 131 (80.4%) completed the survey. The average score of all domains at 3 months was 58, compared to 79 at twelve months and 81 in the control group. There was a statistically significant increase from 3 and 12 and 6 and 12 months (figure 1). At twelve months participants recovered to levels of the healthy control group (N=459), except for the ICU group, who still experienced bodily pain and decreased physical function. The improvement was most noticeable in the domains of social functioning, role limitations – physical and role limitations – emotional. The percentage of patients with abnormal total HADS scores (cutoff at 16) and PCL5- scores (cutoff at 33) at 3 months decreased from 27.8 to 22.1% and 18.9 to 7.6% at 12 months, respectively (figure 2 and 3). Figure 1. RAND-36: Health-related quality of life after COVID-19 of all patients. Blue line is after 3 months, orange line is after 6 months, green line is after 12 months, yellow line is healthy control. The p-value in the right-upper corner shows statistical significant difference between all total scores, the asterisks indicate significance between groups. PF = physical functioning; SF = social functioning; RP = role limitations–physical; RE = role limitations–emotional; MH = mental health; VT = vitality; BP = pain; GH = general health; HC = health change. Figure 2 The blue column is after 3 months, the orange after 6 months and the green after 12 months. The numbers above the columns are percentages per group. Figure 3 The blue column is after 3 months, the orange after 6 months and the green after 12 months. The numbers above the columns are percentages per group. Conclusion Although, COVID-19 may cause a decreased health-related quality of life and impaired mental health, this study shows important recovery up to normal levels after one year. Disclosures All Authors: No reported disclosures

. Characteristics of SARS-CoV-2+ EPICC participants, and illness duration among those with 28+ days post-symptom onset survey data collection.  . Symptoms reported by EPICC participants with illnesses longer than 28 days; 1B. Percent of participants with organ system specific diagnoses on each day, 90 days pre-and post-symptom onset; 1C. Odds of organ system specific diagnoses within each month, +/-3 months of symptom onset, were calculated using generalized linear models, controlling for age, sex, and race and included participants as a random effect. Odds shown are relative to the earliest period included in the model, 61-90 days before onset.
Conclusion. In this MHS cohort, a significant proportion of participants had persistent symptoms and cardiovascular disease diagnoses 3 months after COVID-19 illness onset. These findings emphasize the long-term morbidity of COVID-19 and the importance of mitigating SARS-CoV-2 infections. Further analyses will evaluate demographic, clinical, and biomarker predictors of medium-to-long term organ-specific post-acute sequelae.
Disclosures. Simon Pollett, MBBS, Astra Zeneca (Other Financial or Material Support, HJF, in support of USU IDCRP, funded under a CRADA to augment the conduct of an unrelated Phase III COVID-19 vaccine trial sponsored by AstraZeneca as part of USG response (unrelated work)) Ryan C. Maves, MD, EMD Serono (Advisor or Review Panel member)Heron Therapeutics (Advisor or Review Panel member) David A. Lindholm, MD, American Board of Internal Medicine (Individual(s) Involved: Self): Member of Auxiliary R&D Infectious Disease Item-Writer Task Force. No financial support received. No exam questions will be disclosed ., Other Financial or Material Support 35. Health-related quality of life in COVID-19 survivors after 12 months, a prospective cohort study. Sebastiaan Siegerink 1 ; Marië Nijpels, n/a 1 ; Sander Albers, n/a 1 ; Frédérique Jurgens, n/a 1 ; Felix K. Pettai, n/a 1 ; Laura Samwel, n/a 1 ; Joost Vanhommerig, n/a 1 ; Paul Bresser, n/a 1 ; Marieke de Regt, n/a 1 ; Birit Broekman, n/a 1 ; Kees Brinkman, n/a 1 ; 1 OLVG Amsterdam, Amsterdam, Noord-Holland, Netherlands IMPACD2

Session: O-07. COVID-19 Complications, Co-infections and Clinical Outcomes 2
Background. The long-term effects of COVID-19 are still unknown. This study aims to assess the impact of COVID-19 among survivors after one year. S26 • OFID 2021:8 (Suppl 1) • Abstracts Methods. All confirmed COVID-19 cases who presented at OLVG hospital in Amsterdam during the first wave of the COVID-19 pandemic were invited to participate in our prospective observational cohort study. The participants were divided into three subgroups: patients not admitted, admitted to the general ward and admitted to the ICU. Questionnaires were sent at 3, 6 and 12 months after presentation. We used the Research and Development -36-item health survey, the Hospital Anxiety and Depression Scale and the PTSS Checklist for DSM-5. We compared the RAND-36 scores at the timepoints with a Dutch healthy control population in 2020 and between the three subgroups using the Kruskal-Wallis test and the Mann-Whitney U test.
Results. Of the 466 confirmed cases, 75 patients died of COVID-19, 64 patients were lost to follow up and 12 patients were excluded because they were unable to complete the questionnaires due to mental illness or cognitive impairment, they moved back to their home country or refused to participate. Of the remaining 315 patients, 182 (57.8%) completed the questionnaires at 3 months. Subsequently, 163 patients provided informed consent for follow up. At 6 and 12 months, 98 (60.1%) and 131 (80.4%) completed the survey. The average score of all domains at 3 months was 58, compared to 79 at twelve months and 81 in the control group. There was a statistically significant increase from 3 and 12 and 6 and 12 months (figure 1). At twelve months participants recovered to levels of the healthy control group (N=459), except for the ICU group, who still experienced bodily pain and decreased physical function. The improvement was most noticeable in the domains of social functioning, role limitations -physical and role limitations -emotional. The percentage of patients with abnormal total HADS scores (cutoff at 16) and PCL5-scores (cutoff at 33) at 3 months decreased from 27.8 to 22.1% and 18.9 to 7.6% at 12 months, respectively ( figure 2 and 3). Blue line is after 3 months, orange line is after 6 months, green line is after 12 months, yellow line is healthy control. The p-value in the right-upper corner shows statistical significant difference between all total scores, the asterisks indicate significance between groups. PF = physical functioning; SF = social functioning; RP = role limitations-physical; RE = role limitations-emotional; MH = mental health; VT = vitality; BP = pain; GH = general health; HC = health change.

Figure 2
The blue column is after 3 months, the orange after 6 months and the green after 12 months. The numbers above the columns are percentages per group.

Figure 3
The blue column is after 3 months, the orange after 6 months and the green after 12 months. The numbers above the columns are percentages per group.
Conclusion. Although, COVID-19 may cause a decreased health-related quality of life and impaired mental health, this study shows important recovery up to normal levels after one year.
Disclosures. All Authors: No reported disclosures Background. Little is known about risk factors for readmission after COVID-19 hospitalizations. Knowledge of these factors may help to identify patients at increased risk and may help to prevent these rehospitalizations.

Clinical Features of and Risk Factors for 30-day Readmission after an Initial
Methods. This historical cohort study was conducted at a tertiary care academic medical center. We included COVID-19 cases diagnosed by reverse-transcriptase polymerase-chain-reaction (RT-PCR) assay between March 8 th and June 14 th , 2020. Patients readmitted within 30 days were identified. Using the electronic medical record, we collected data on demographic and clinical information. Data were analyzed using Student's t-test, the chi-squared test and multivariable logistic regression.
Results. We included 391 patients who survived after the index hospitalization for COVID-19. The readmission rate was 13.3% (52/391). The mean time to readmission was 9.2 ± 7.9 days. The mean age (±SD) was 66.3 ± 18.6 years, 44.2% were male, and 78.8% were black/African-American. The most common presenting complaint was shortness of breath (50%). The most frequent diagnosis during the readmission was infectious process (57.7%). The mortality rate on readmission was 11.5%. Patients with a 30-day readmission were older than those not readmitted, mean age (±SD) 66.3 ± 18.6 vs. 61.0 ± 16.0, respectively (p=0.03). Readmitted patients also had a higher prevalence of heart failure and renal disease as comorbidities. Elevated alanine aminotransferase (AST) and low albumin level were also associated with readmission (Table 1). Intensive care unit (ICU) admission or mechanical ventilation during the index admission did not increase the risk of readmission. From multivariable analysis, independent predictors of 30-day readmission were higher Charlson score (p=0.004), higher creatinine on admission in the index hospitalization (p=0.009), and presence of rhabdomyolysis during the index hospitalization (p=0.039) ( Table 2).