Most Patients Hospitalized With COVID-19 Show at Least 1 Symptom 6 Months Post Infection

A recent cohort study assessing the long-term effects of the coronavirus disease 2019 (COVID-19) in hospitalized patients in Wuhan, China has demonstrated that more than 3 quarters have at least 1 ongoing symptom 6 months after initial infection. The findings from the study were published in The Lancet.

The study included 1,733 participants who were discharged from the hospital with a median age of 57 years old. Each patient had follow up visits with a median time of 186 days after release. The most common symptoms identified were muscle weakness and fatigue (63%), anxiety or depression (23%) and sleep difficulties (26%). Findings also showed that after 6 months, 94 of the patients had their levels of neutralizing antibodies fall by more than half (52.5%), raising concerns about the potential for a second infection.

"Because COVID-19 is such a new disease, we are only beginning to understand some of its long-term effects on patients’ health. Our analysis indicates that most patients continue to live with at least some of the effects of the virus after leaving hospital, and highlights a need for post-discharge care, particularly for those who experience severe infections,” Bin Cao, a professor from Capital Medical University said. “Our work also underscores the importance of conducting longer follow-up studies in larger populations in order to understand the full spectrum of effects that COVID-19 can have on people.”

Each participant had face to face interviews, where they filled out questionnaires evaluating their health-related quality of life and symptoms. 390 of the participants also underwent lab tests, lung assessments and physical examinations, like a 6-minute walking test. 76% of the patients reported persistent symptoms at follow-up.

Of the 390 who completed further testing, 349 took part in the lung assessment, with 41 unable to complete it due to poor compliance. Patients who developed a more severe case of the disease commonly showed a reduced functioning of the lungs, with 56% experiencing reduced oxygen flow from the lungs to the bloodstream. The severe patients also performed worse in the walking test, with 29% walking less than the lower limit of the normal range. Testing also showed that 13% of patients showed a decrease in kidney function.

“Even though the study offers a comprehensive clinical picture of the aftermath of COVID-19 in hospitalized patients, only 4% were admitted to an intensive care unit (ICU), rendering the information about the long-term consequences in this particular cohort inconclusive,” the authors wrote. “Nonetheless, previous research on patient outcomes after ICU stays suggests that several COVID-19 patients who were critically ill while hospitalized will subsequently face impairments regarding their cognitive and mental health and/or physical function far beyond their hospital discharge.”