Seven in 10 people hospitalized for Covid-19 have not fully recovered five months after discharge, a new study finds.
The Covid survivors continued to experience concerns with their mental and physical health, with 1 in 5 people developing a new disability, and a similar number either not working or having to change jobs due to their health, according to findings by UK researchers.
The people most likely to have persistent symptoms were middle-age White women who developed severe Covid-19, and who had at least two conditions that put them at greater risk of severe disease, such as diabetes, asthma or heart disease.
“Our results show a large burden of symptoms, mental and physical health problems and evidence of organ damage five months after discharge with COVID-19,” Rachael Evans, an associate professor at the University of Leicester and respiratory consultant at Leicester’s hospitals, said in a statement.
“It is also clear that those who required mechanical ventilation and were admitted to intensive care take longer to recover,” she said, but highlighted that much of the wide variety of persistent problems was not explained by the severity illness, indicating other underlying reasons.
The UK-wide study analyzed 1,077 people who were discharged from hospital between March and November 2020, who developed Covid-19. Among them, 67% where White, 36% were women and 50% had at least two conditions that put them at risk of severe disease.
When the participants were followed up five months later, only 29% of people said they felt fully recovered, while more than 90% of people had at least one persistent symptom, and most experienced an average of nine ongoing symptoms.
The 10 most common symptoms were muscle pain, fatigue, physical slowing down, impaired sleep quality, joint pain or swelling, limb weakness, breathlessness, pain, short-term memory loss, and slowed thinking, according to the study, which has not been peer-reviewed.
Mental health was also affected, with more than 25% of people having clinical symptoms of anxiety or depression and 12% having symptoms of post-traumatic stress disorder (PTSD).
The participants were also divided into four groups based on the severity of their symptoms at follow-up: Very severe, severe, moderate and mild, with 46% of people in this last group.
Based on these groups, the researchers also identified a potential cause for the ongoing effect on health.
Five months after discharge, patients with the most severe symptoms had higher levels of a protein called C-reactive protein, which is associated with inflammation in the body, explained Louise Wain, chair in respiratory research at the University of Leicester and co-investigator on the study.
“From previous studies, it is known that systemic inflammation is associated with poor recovery from illnesses across the disease spectrum,” said Wain.
In the groups, persistent inflammation in the body determined by this C-reactive protein was related to the severity of symptoms, but not how severe the participant had been affected by Covid-19 when in hospital.
“We also know that autoimmunity, where the body has an immune response to its own healthy cells and organs, is more common in middle-aged women. This may explain why post-COVID syndrome seems to be more prevalent in this group, but further investigation is needed to fully understand the processes.”
The researchers are now calling for more follow-up care to be provided for Covid survivors.
Our findings support the need for a proactive approach to clinical follow-up with a holistic assessment to include symptoms, mental and physical health, but also an objective assessment for cognition,” said Chris Brightling, a professor of respiratory medicine at the University of Leicester and the chief investigator for study.
“Continued study of the trajectory of recovery over a longer timeframe, coupled with greater understanding of the biology underpinning post-COVID symptoms, will further inform approaches to the clinical management post-COVID19 infection,” he said.
The study participants will be assessed again at 12 months to gather more data on the long-term impact of Covid-19.
Professor Chris Whitty, the UK’s chief medical officer and co-lead for the National Institute for Health Research, said in a statement: “It is important that we work out what exactly the various elements of what is currently termed ‘Long Covid’ are so we can target actions to prevent and treat people suffering with long term effects.”
“I know Long COVID can have a lasting and debilitating impact on the lives of those affected and I’m determined to improve the care we can provide,” UK Health and Social Care Secretary Matt Hancock said in a statement.
“Studies like this help us to rapidly build our understanding of the impact of the condition and we are working to develop new research so we can support and treat people.”