Chapter 4 100 hospitals, COVID-19 diagnosis was based on positive PCR and/or SARS-CoV-2-specific serology (using the WANTAI SARS-CoV-2 Ab ELISA[13]); the latter method was used as an additional diagnostic tool for cases with high clinical suspicion of COVID-19 during periods of extreme pressure on tertiary care. COVID-19 patients who had been admitted to ICU were enrolled following step-down from ICU. A limited number of hospitalised patients were contacted after discharge up to 30 June 2020 and within three months following SARS-CoV-2 diagnosis in order to include participants infected during the ‘first wave’ of COVID-19 in the Netherlands. Recruitment is ongoing; for the present analyses we included all participants with a follow-up of at least one month by 1 June 2021. Eligibility criteria included prior laboratory confirmation of SARS-CoV-2 infection by PCR, validated antigen test or serology, as stated above. Further inclusion criteria were: aged 16-85 years, residing in the municipal region of Amsterdam, adequate understanding of Dutch or English. Individuals residing in a nursing home prior to SARS-CoV-2 infection were excluded due to inability to travel independently for follow-up appointments. Individuals with mental disorders that would interfere with adherence to study procedures were also excluded. The RECoVERED study was approved by the medical ethical review board of the Amsterdam University Medical Centre (NL73759.018.20). All participants provided written informed consent. Study procedures Study visits at enrolment (D0 study visit) and day 7 (D7 study visit) took place at the participant’s home (if non-hospitalised) or on the hospital ward (if hospitalised). Subsequent visits took place at one of two study sites (PHSA and Amsterdam UMC [location AMC]). All visits were performed by trained medical study staff. At D0, D7 and D28 study visits, a symptom questionnaire on the presence, start and stop dates, and severity of 18 symptoms (based on the WHO Case Report Form [14]) was completed (Figure S2). From month 2 after enrolment onwards, participants completed monthly online questionnaires on the presence of symptoms. Heart rate (HR), respiratory rate (RR) and oxygen saturation (SpO2) were measured at D0 and D7 study visits, or retrieved from hospital records for retrospectively-enrolled participants. Socio-demographic data and data on past medical history, COVID-19-related complications, treatment, and investigations were collected during participant interview. Self-reported data were verified with electronic medical records when available.
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