Risk factors and incidence of Long-COVID syndrome in hospitalized patients: does remdesivir have a protective effect?

BACKGROUND The definition of "Long-COVID syndrome" (LCS) is still debated and describes the persistence of symptoms after viral clearance in hospitalized or non-hospitalized patients affected by coronavirus disease 2019 (COVID-19). AIM In this study we examined the prevalence and the risk factors of LCS in a cohort of patients with previous COVID-19 and followed for at least six months of follow-up. DESIGN We conducted a prospective study including all hospitalized patients affected by COVID-19 at our center of Infectious Diseases (Vercelli, Italy) admitted between 10th March 2020 to 15th January 2021 for at least six months after discharge. Two follow-up visits were performed: after 1 and six months after hospital discharge. Clinical, laboratory and radiological data were recorded at each visit. RESULTS 449 patients were included in the analysis. The LCS was diagnosed in 322 subjects at visit 1 (71.7%) and in 206 at visit 2 (45.9); according to the PCFS scale we observed 147 patients with values 2-3 and 175 with values >3 at visit 1; at visit 2 133 subjects had the score between 2-3 and 73 > 3. In multivariate analysis, ICU admission (OR = 2.551; 95%CI = 1.998-6.819; p = 0.019), time of hospitalization (OR = 2.255; 95%CI = 1.018-6.992; p = 0.016) and treatment with remdesivir (OR = 0.641; 95%CI = 0.413-0.782; p < 0.001) were independent predictors of LCS. CONCLUSIONS Treatment with remdesivir leads to a 35.9% reduction in LCS rate in follow-up. Severity of illness, need of ICU admission and length of hospital stay were factor associated with the persistence of PCS at six months of follow-up.