Researchers from the China-Japan Friendship Hospital analyzed the records of 1,192 people who had been hospitalized at Jin Yin-tan Hospital in Wuhan, China, and were discharged between January 7 and May 29, 2020.
The researchers reviewed six months, 12 months and two years after the patients were discharged and asked for their subjective assessment of symptoms. The participants were also evaluated using more objective medical tests, including pulmonary function tests, CT scans, and six-minute walk tests.
Overall, the participants were in worse health two years later. Those who had persistent COVID-19 symptoms listed pain, fatigue, trouble sleeping, and problems with their mental health. Patients who received high-level respiratory support while hospitalized had more long-term lung problems than others.
Participants with persistent symptoms also went to the doctor more often than before the pandemic. They found it more difficult to exercise and generally reported a poorer quality of life. Most had returned to work, but it is not clear if they were working at the same level as before they got sick.
Study co-author Dr. Bin Cao, of the China-Japan Friendship Hospital, hopes the research will encourage doctors to ask follow-up questions of their patients who had Covid-19, even years after their initial infection.
“There is a clear need to provide ongoing support to a significant proportion of people who have had COVID-19 and to understand how vaccines, emerging treatments and variants affect long-term health outcomes,” Cao said in a news release. .
The study has some limitations. The researchers did not compare the results with people who were hospitalized for reasons other than COVID to see if they also had persistent symptoms. They compared the hospitalized group with people in the community who never had covid-19; that group also had health problems a year later, but that happened in about half as many people as in the hospitalized group.
Another limitation was that the research involved a single hospital, so the results may not be universal for all hospitalized Covid-19 patients. At the beginning of the pandemic, patients were generally staying in the hospital longer than they are now, and that could have an effect on the duration of symptoms. And because the research was done early in the pandemic, it’s not clear if there would be similar results in people who got sick with later variants of the coronavirus or those who had been vaccinated.
“The only thing I know I can safely offer Covid patients for a long time is vaccination,” said Sanghavi, who was not involved in the study. “When we compare unvaccinated patients with vaccinated patients and look at the incidence of prolonged COVID symptoms, vaccinated patients have less severe symptoms and less often have prolonged COVID.”
“Right now, these patients sometimes seem like an afterthought,” Sanghavi said.
“The study potentially points to how many people will need help. I don’t know if you’ve tried to get an appointment for a primary care visit, but it can take weeks or even months in many places. And that’s just for a simple wellness check – forget about the prolonged covid. That’s a lot longer,” he said.
Sanghavi said more doctors will also need to be trained on how to help people with prolonged Covid. “Our health care system is not prepared for the kind of influx of patients this condition will bring.”
Erlandson said so many people want to know more about prolonged Covid that her colleagues haven’t even had to announce the trial; There is a waiting list to get in.
The new research aligns with what staff are seeing at those long-distance clinics.
“This is similar to what we’re hearing from patients in the US who are still experiencing symptoms at two years, particularly in the first wave of patients in the pandemic. We’ve heard this anecdotally, so it’s always good to see things published,” said Erlandson, who was not involved in the study. Patients in his clinic also have similar symptoms, with sleep difficulties and fatigue being the most common.
He stressed that people don’t have to be hospitalized for Covid-19 to have persistent symptoms, and he hopes future research will capture how long non-hospitalized people experience symptoms.
Erlandson also noted that some of the study participants improved after 12 months, but worsened again after two years.
“I think these long studies are interesting to see that it’s not progressive improvement. People do fluctuate a little bit in their improvements,” he said.
Erlandson said he will be curious if the participants improved beyond those two years or if Covid-19 will become a chronic condition. Doctors can treat certain symptoms, but there is no specific treatment for prolonged Covid.
“Unless they have some kind of treatment, I’m concerned that it will have a long-term impact on disability and function for some patients,” he said.