PhD defence J.C. (Julia) Berentschot

Below is a brief summary of the dissertation: 

This thesis investigates long-term health outcomes and aftercare pathways in patients following hospitalization for COVID-19 within the Dutch health care system. It focuses on the trajectories of various health outcomes, subgroup comparisons, and risk factors for health problems up to one, two, and three years after hospitalization. 
This thesis shows that many patients continue to experience long-term health problems after hospitalization for COVID-19, while showing good recovery in objectively measured physical function. More than half reported persistent fatigue, impaired fitness, and problems with memory and concentration even three years after hospital discharge, along with reduced health-related quality of life and difficulties resuming work. A subset of patients experienced post-exertional malaise (PEM), with many reporting poorer health outcomes compared to those without PEM, suggesting a more sever phenotype of long COVID. Early identification of PEM is crucial for guiding personalized aftercare strategies and preventing potential harm.
Our research shows that long-term health problems were prevalent across the entire cohort, regardless of ICU admission during the acute phase. Female patients and those with pre-existing pulmonary diseases were particularly at higher risk of poorer health outcomes. Despite ongoing health problems, patients were generally satisfied with the aftercare received. However, one third of patients reported unmet needs during COVID-19 aftercare, primarily related to information provision. Long COVID is a complex and heterogeneous condition; its underlying mechanisms are poorly understood. Our research found persistent immune dysregulation in patients with ongoing symptoms after hospitalization for COVID-19. Together, this thesis enhances our understanding of long-term health outcomes after hospitalization for COVID-19. The findings underscore the complex interplay of multiple factors that must be considered in COVID-19 aftercare, necessitating a personalized approach.