More than half of people hospitalized with Covid-19 still have at least one symptom two years after they were first infected, according to the longest follow-up study of its kind.
Although physical and mental health generally improves over time, the analysis suggests that coronavirus patients discharged from hospital still tend to have poorer health and quality of life than the general population. The research was published in the Lancet Respiratory Medicine.
“Our results indicate that for a certain proportion of hospitalized Covid-19 survivors, although they may have cleared the initial infection, it takes more than two years to fully recover,” said lead author Professor Bin. Cao, from the China-Japan Friendship Hospital in China.
Until now, the long-term health effects of Covid-19 have remained largely unknown, as the longest follow-up studies to date have lasted around a year. The lack of data on pre-Covid-19 health status and comparisons with the general population in most studies has also made it difficult to determine how well patients with Covid-19 have recovered.
For the new study, the researchers sought to analyze the long-term health outcomes of hospitalized survivors of Covid-19, as well as the specific health impacts of long Covid. They assessed the health of 1,192 participants with acute Covid-19 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 average age was 57 at discharge.
Assessments included a six-minute walk test, lab tests, and questionnaires on symptoms, mental health, health-related quality of life, return to work, and post-discharge healthcare utilization. . Two-year health outcomes were determined using a control group matched to age, gender and comorbidities of people from the general population with no history of Covid-19 infection.
Six months after initially falling ill, 68% of patients reported at least one long Covid symptom. Two years after infection, more than half – 55% – were still reporting symptoms. Fatigue or muscle weakness were most commonly reported. Regardless of the severity of their initial illness, two years later, one in 10 – 11% – patients had not returned to work.
Two years after initially falling ill, patients were in poorer health than the general population, with 31% reporting fatigue or muscle weakness and 31% reporting sleep disturbances. The proportion of non-Covid-19 participants reporting these symptoms was 5% and 14% respectively. Covid-19 patients were also more likely to report a number of other symptoms, including joint pain, palpitations, dizziness and headache. In quality of life questionnaires, Covid-19 survivors also reported pain or discomfort and anxiety or depression more often than non-Covid-19 participants.
The authors acknowledged the limitations of their study. Being a single-center study from the start of the pandemic, the findings may not directly extend to long-term health outcomes of patients infected with later variants, the Lancet Respiratory Medicine said. Like most Covid-19 tracking studies, there is also potential for information bias when analyzing self-reported health outcomes.
“Continued follow-up of Covid-19 survivors, particularly those with symptoms of long Covid, is essential to understanding the longer course of the disease, as is further exploration of the benefits of rehabilitation programs for recovery. “Cao said. “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.”