A first-of-its-kind survey has revealed that only one in four people who have been hospitalized with Covid feel fully recovered a year after being discharged.
The feeling of full recovery from the disease is lower for women (32% less likely), people with obesity (50% less likely) and those who had to use mechanical ventilation during the hospitalization period (58%).
The data are from a large post-hospitalization study by Covid (PHOSP-Covid, in English), conducted in the United Kingdom and published last Saturday (23) in the specialized journal The Lancet Respiratory Medicine. The research results were also presented at the European Congress of Clinical Microbiology and Infectious Diseases, which takes place in Lisbon (Portugal) from 23 to 26 April.
The research is led by Christopher Brightling, Rachel Evans and Louis Wain, professors at the Center for Biomedical Research at the National Institute of Health at the University of Leicester.
The study followed 2,320 patients who were discharged from hospital after a coronavirus infection between March 7, 2020 and April 18, 2021. The first assessment was five months after hospital discharge, while the second was done one year after leaving the hospital. .
At the time of reporting, 807 participants (33%) had completed the one-year follow-up period. The study remains in progress.
With these patients, the researchers could see that a quarter of them (205, or 25.4%) were fully recovered one year after hospital discharge. Recovery assessment consisted of patient reports combined with analysis of physical performance and vital organ function.
The researchers also took blood samples to assess the presence of inflammatory proteins — some studies have already shown that the presence of antibodies against the body itself or markers of inflammation may be related to long-term Covid.
According to the assessments, the most persistent symptoms after one year of hospital discharge were fatigue (60.1%), muscle pain (54.6%), loss of mobility (52.9%), sleep problems (52, 3%), shortness of breath (51.4%), mental confusion (46.7%), body aches (46.6%) and memory loss (44.6%). Swelling (47.6%) and weakness in the limbs (41.9%) were also reported, but these were lower than at the five-month assessment (49.1% and 47.6%, respectively).
According to the survey, the proportion of patients who said they had fully recovered did not change significantly between the first assessment, at five months (25.5%), and the second, at one year (28.9%).
To try to elucidate the mechanisms behind long Covid, the authors divided patients into four groups according to the severity of Covid sequelae: the first group had very severe physical and mental disabilities (319 patients or 20%); the second, a severe physical and mental disability (493 or 11%); the third, moderate physical disability with cognitive impairment (179 or 11%); and the fourth, a mild physical and mental disability (645 or 39%).
Compared with the moderately disabled group, patients with very severe physical and mental disabilities had a higher proportion of women and obese people, indicating both factors as predictive of not fully recovering after one year.
“In our analysis, these two factors [obesidade e sexo feminino] were also associated with more severe ongoing health impairment, including poor exercise performance and poor quality of life after one year, illuminating that these groups may need longer-term interventions such as rehabilitation.
According to the authors, the lack of drugs to treat the effects of long-term Covid or of specific therapies to treat the sequelae point to a need for greater integration of physical and mental care.
“The severity and compromise of physical and mental health in Covid-19 highlights the need not only for a close integration between physical and mental health care, including assessments and interventions, but also for knowledge exchanges between health professionals to better service”, they say.
“Our study emphasizes the urgent need for healthcare services that support this large and growing population of patients who experience a significant burden of symptoms one year after discharge, including reduced motor skills and quality of life. Without effective treatments, Covid long term can become a new long-term health condition with high prevalence in society”, they conclude.