Most hospitalized COVID patients still recovering a year after discharge
New research published in The Lancet Respiratory Medicine has followed the recovery of more than 2,000 hospitalized COVID-19 patients. The findings show barely one in four patients reported feeling fully recovered from COVID-19 a year after being discharged from hospital.
The ongoing study tracked a large number of adults in the UK admitted to hospital for COVID-19 between March 2020 and April 2021. The cohort participated in two follow-up assessments (at five months and one year) after being discharged from hospital.
During the follow-up assessments the subjects completed physiological and cognitive tests, supplied blood samples, and filled out subjective questionnaires. At the five-month follow-up only 26 percent of people reported feeling fully recovered from their bout of COVID-19, and at the one-year follow-up only 29 percent said they were fully recovered.
“The limited recovery from five months to one year after hospitalization in our study across symptoms, mental health, exercise capacity, organ impairment, and quality-of-life is striking,” said Rachael Evans, one of the researchers leading the project.
The study identified several risk factors that heightened a patient’s likelihood of experiencing lingering health issues following COVID-19 hospitalization. Females and obese subjects were more likely to report not feeling fully recovered one year later. The most common persistent symptoms reported were fatigue, muscle pain, physically slowing down, poor sleep, and breathlessness.
The researchers were also able to stratify those patients experiencing long COVID into four clusters, based on their symptom severity. The clusters ranged from very severe physical and mental health impairments (20 percent of the long COVID cohort) to mild mental and physical health impairment (39 percent of the cohort).
“Our findings of persistent systemic inflammation, particularly in those in the very severe and moderate with cognitive impairment clusters, suggest that these groups might respond to anti-inflammatory strategies,” reported Louise Wain, another researcher working on the project. “The concordance of the severity of physical and mental health impairment in long COVID highlights the need not only for close integration between physical and mental health care for patients with long COVID, including assessment and interventions, but also for knowledge transfer between health-care professionals to improve patient care.”
The researchers are clear in noting this cohort of patients did not include vaccinated subjects so further work will have to track long-term outcomes for those hospitalized with vaccine breakthrough infections. The data also covers a period of time before the Omicron variant emerged, so it is unclear whether these numbers apply to infections with newer variants of SARS-CoV-2.
It is certainly too soon to extrapolate the impact of Omicron on long COVID worldwide but researchers are beginning to see the long-term impacts of earlier variants. A recent meta-analysis from the University of Michigan School of Public Health looked at data from 1.6 million COVID-19 patients encompassing 50 studies and found nearly half of all those infected with SARS-CoV-2 reported some kind of persistent symptom four months after their initial diagnosis.
That meta-analysis found 34 percent of non-hospitalized COVID-19 patients showed lingering symptoms at four months. And again, fatigue was the most prominent persistent symptom.
Christopher Brightling, an author on the new UK study, said the findings highlight a large population of COVID-19 patients from 2020 and 2021 are suffering from long COVID. And regardless of how many newer infections will be linked to long COVID in the future there is already a massive group of people struck with this chronic disease.
“Our study highlights an urgent need for health-care services to support this large and rapidly increasing patient population in whom a substantial burden of symptoms exist, including reduced exercise capacity and substantially decreased health-related quality of life one year after hospital discharge,” said Brightling. “Without effective treatments, long COVID could become a highly prevalent new long-term condition.”
The new study was published in The Lancet Respiratory Medicine.