More than half of people who are hospitalized with Covid-19 still have at least one symptom two years after they were first infected, according to the longest-running follow-up study of its kind.
While overall physical and mental health improves over time, the analysis indicates that coronavirus patients who have been discharged from hospital continue to have poorer health and quality of life compared to the general population. The research was published in The Lancet Respiratory Medicine.
Lead author, Professor Ben Kao, from China, said: “Our findings suggest that for a certain proportion of hospitalized Covid-19 survivors, while they may have cleared the initial infection, more than two years are needed to fully recover. “.
So far, the long-term health effects of Covid-19 have remained largely unknown, with the longest follow-up studies to date spanning about a year. The lack of pre-Covid-19 health status data and comparisons with the general population in most studies also made it difficult to determine how well Covid-19 patients recovered.
For the new study, the researchers sought to analyze the long-term health outcomes of hospitalized Covid-19 survivors, as well as the specific health effects of prolonged Covid-19. They evaluated the health of 1,192 participants with severe Covid-19 who were treated at Jin Yin-tan Hospital in Wuhan, China, between January 7 and May 29, 2020, at six months, 12 months and two years. The median age was 57 at discharge.
Assessments included a six-minute walking test, lab tests, and questionnaires about symptoms, mental health, health-related quality of life, and whether they returned to work and health care use after hospital discharge. Health outcomes were determined at 2 years of age using a control group matched for age, sex, and comorbidities in the general population with no history of Covid-19 infection.
After six months of initially ill, 68% of patients reported displaying at least one prolonged Covid-19 symptom. Two years after infection, more than half – 55% – still report symptoms. Fatigue or muscle weakness was reported most often. Regardless of the severity of the initial disease, after two years, one in 10 patients – 11% – had not returned to work.
After two years of initially ill, patients were in lower health than the general population, with 31% reporting muscle fatigue or weakness and 31% reporting difficulties sleeping. The proportion of non-Covid-19 participants who reported these symptoms was 5% and 14%, respectively. Covid-19 patients were more likely to report a number of other symptoms including joint pain, heart palpitations, dizziness and headache. In quality of life questionnaires, Covid-19 survivors also reported more often pain or discomfort, anxiety or depression than non-Covid-19 participants.
The authors acknowledge the limitations of their study. Because it was one central study from early in the epidemic, the results may not extend directly to the long-term health outcomes of patients with later variants, according to The Lancet Respiratory Medicine. Like most Covid-19 follow-up studies, there is also potential for information bias when analyzing self-reported health outcomes.
“Continuous follow-up of Covid-19 survivors, especially those with prolonged Covid symptoms, is essential to understanding the longer course of the disease, as well as further exploring the benefits of rehabilitation programs for recovery,” Kao said. “There is a clear need to provide ongoing support to the large proportion of people who have contracted Covid-19, and to understand how vaccines, treatments and emerging variables affect long-term health outcomes.”