Corona: 76 percent of hospitalized patients have long-term consequences

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Many millions of people around the world have recovered from being infected with the coronavirus. But what recovery really means remains unclear. A new study has now looked at patients who had to be hospitalized during their infection – and provides an insight into their alarming fate six months after their illness.

The study published on Friday in the journal The Lancet found that 76 percent of Covid-19 patients hospitalized in Wuhan still had at least one symptom six months after their illness. A total of 1,733 adult patients diagnosed with Covid-19 between January and May 2020 were followed. The researchers followed these patients from June to September and performed laboratory tests, physical exams, pulmonary function tests, and face-to-face interviews. Around 63 percent of the patients in the study complained of fatigue or muscle weakness even after six months – the most frequently observed long-term symptoms. Another 26 percent said they had trouble sleeping, while 23 percent reported they had experienced anxiety or depression since becoming ill.

According to the researchers, this is the most comprehensive study to date on long-term symptoms in previously hospitalized Covid-19 patients. She also has the longest follow-up of any previous investigation on the subject. “Because Covid-19 is such a new disease, we are only just beginning to understand some of its long-term effects on patient health,” Bin Cao, one of the study’s authors, said in a statement. “Our analysis suggests that after hospital discharge, most patients will continue to live with at least some of the effects of the virus. It underscores the need for follow-up care after discharge, especially for those who experience severe infections. “

“A forgotten group”

390 patients in the study completed a lung function test approximately six months after their diagnosis. It showed that the people with the most severe disease courses – i.e. those who had received additional oxygen during their illness or were connected to a ventilator – were more likely to suffer from persistently impaired lung function. They also had more difficulty walking than patients with milder disease. Around 822 patients in the study had normal kidney function during their hospital stay, but 13 percent of them were diagnosed with decreased kidney function six months later.

Because the new study only looked at patients who had to be hospitalized, the results may not be applicable to all those with long-term effects of illness. Until recently, such individuals were “a forgotten group,” said Steven Deeks, professor of medicine at the University of California, told “Everything has been about acute disease management so far, which is understandable,” he said. “But now there is widespread acceptance that these long-term complications exist and that they can severely limit those affected.”

Doctors still don’t have a common term for this group of long-lasting Covid-19 symptoms, but some researchers refer to them as “Long Covid”. Deeks said he preferred the term “post-acute Covid syndrome” or post-Covid syndrome in German. It is not yet known how many people are affected in total. A study by researchers from the UK in August estimated that one in ten corona patients will go through an extended period of illness. A study by King’s College London, which is still awaiting review, found that almost 100 out of 4,000 Covid 19 patients had not recovered after twelve weeks of illness.

Long-term symptoms can be similar to chronic fatigue syndrome

The new study joins a growing body of research suggesting fatigue is a common symptom of long-term illness. In the King’s College study, almost 98 percent of patients who were still sick after four weeks said they were tired. Some patients have also reported feeling weak or foggy after too much physical activity – a hallmark of chronic fatigue syndrome that can last for years or more.

Many patients who contracted Sars had similar long-term symptoms – a useful clue, as Sars and the new coronavirus share about 80 percent of their genetic code. A follow-up study of Sars patients in Hong Kong found that 27 percent of them met clinical criteria for chronic fatigue syndrome four years after they started their illness. And a study of 109 Sars patients in Toronto found that more than half had not returned to work a year after being discharged from the intensive care unit because of persistent fatigue and weakness. This eventually affected the mental health of the Sars patients as well. More than 40 percent of the participants in the Hong Kong study had active psychiatric illnesses, including post-traumatic stress disorder and depression. Only three percent of them had a history of these diseases prior to being diagnosed with Sars.

Mental health problems, Deeks said, are a “big part of the package” when it comes to post-Covid syndrome. He suspects that the new condition is different from chronic fatigue syndrome, although there is likely to be some overlap. It could take years of research to understand why certain coronavirus symptoms persist, he added. “There will be a whole series of studies that are strictly observational. Here we report what we saw in our clinic,” said Deeks. “That will help, but there won’t be a control group.” An ideal study, Deeks said, would take large groups of healthy people and then follow them over a longer period of time. In the group that eventually fell ill with Covid-19, the researchers could analyze the differences – between those patients whose symptoms persist and those who do not. “That can take years,” added Deeks. “And in Covid times that means: decades.”

This article was translated from English by Steffen Bosse. You can find the original here.


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