A year after being hospitalized by Covid-19, half of the patients still experience some symptoms. Although the overall trend is for improvement, the share of those with breathing difficulties increases from 26% to 30%, concluded the largest long-term study done to date with victims of the coronavirus.
The work, carried out with 1,227 patients in China, shows that in most people the symptoms tend to disappear over time. In an assessment made 6 months after admission, 68% of patients still reported some problem, and the number dropped to 49% after one year. Among those who had the most affected quality of life, however, the situation worsened.
The number of those who found it difficult to walk after the Covid-19 episode rose from 6% to 9%, and reports of anxiety or depression increased from 23% to 26%.
The survey, described in a study in the medical journal Lancet, was carried out with patients at the Jin Yin-tan Hospital, in Wuhan, China, the first to receive a large volume of patients at the zero point of the epidemic.
“It is worrying that dyspnea (difficulty breathing), anxiety and depression are more frequent at 12 months than at 6 months, despite the fact that the increase in the proportion was relatively small in our follow-up”, state in a study in the medical journal Lancet os authors of the work. “Our data suggest that full recovery after one year is not possible for some patients.”
According to the scientists, led by Lixue Huang, from the Capital Medical University in Beijing, a relevant factor in predicting long-term symptoms is the patient’s condition during the hospital stay. Those who were admitted to the ICU generally had longer lasting symptoms after leaving the hospital. In those who required mechanical ventilation, the persistence of these symptoms was even longer on average.
Although the study carried out now has been carried out only in China, as it has a large number of patients, it is an important milestone in the medical literature on the disease. Preliminary figures being released by other monitoring groups indicate that more countries will have similar problems.
According to pulmonologist Rosemeri Maurici da Silva, a professor at the Federal University of Santa Catarina, Brazil is heading towards very similar numbers. The doctor coordinates a smaller-scale follow-up study, with 160 patients so far, and says the findings of the Chinese paper are more or less in line with what is seen here.
“In Brazil, a large percentage, something around 60%, must show some manifestation even after a year of the acute phase of the disease”, he says.
According to Silva, it is important that most patients discharged from hospitalization understand that the follow-up does not end there.
“With any symptoms that occur after the acute phase, the person must seek a health service to be evaluated and have adequate treatment”, he says.
In the result of the Chinese study, one of the researchers’ concerns is that, despite a general tendency for improvement to actually exist, it is slower than expected. This means that a certain level of burden on healthcare systems will last for some time, and healthcare managers need to prepare for this.
According to Silva, from UFSC, it is important that respiratory problems gain the attention of public policies, because they are the most persistent in the long term.
“Right now, what we have in pulmonary rehabilitation services in Brazil partially covers patients with chronic respiratory problems, such as bronchial asthma, cystic fibrosis and others. we will have a much larger load of patients, it seems to me that we would have to have a greater structure in this regard”, says the pulmonologist.