Many people report persistent symptoms after contracting Covid 19. The symptoms are summarized under the name Long Covid. A study from Wuhan now provides the most comprehensive analysis to date of the long-term effects in people who have been hospitalized for Covid-19. According to this, every second person still suffers from at least one symptom a year after their discharge, most often fatigue or muscle weakness, and every third person was short of breath. According to the researchers, Long Covid is an ongoing challenge for health systems.
By early August 2021, the Sars-CoV-2 coronavirus had caused more than 200 million confirmed diseases and over 4.3 million deaths worldwide. In addition, there are increasing reports from people who suffer from after-effects of the infection long after the actual illness. These include symptoms such as fatigue, muscle weakness, shortness of breath, as well as depression and anxiety. However, a uniform definition of long covid does not yet exist and little is known about how often and under what conditions long-term effects occur.
Long-term consequences even after a year
A team led by Lixue Huang from Capital Medical University in Beijing has now presented the most extensive analysis of Long Covid to date. To do this, the researchers examined 1,276 former Covid-19 patients who had been treated at the Jin Yin-tan Hospital in Wuhan between January and May 2020. In health checks after six and twelve months, the participants answered questions about their condition, went through laboratory tests and physical exams, and took an endurance test. In some patients, the researchers also performed a lung function test and a chest CT. The comparison group served were people who were not sick with Sars-CoV-2 and who were similar to the people from the study group in terms of age, gender and previous illnesses.
“While most had recovered well, some patients continued to have health problems, especially those who were critically ill during their hospital stay,” says co-author Bin Cao of the China-Japan Friendship Hospital in Beijing. “Our results suggest this that some patients take more than a year to recover. This should be taken into account when planning health care after the pandemic. “
Damage to the lungs
The patients reported fatigue and muscle weakness particularly frequently. These symptoms regressed over time, according to the researchers. While in the examination after six months 68 percent of the participants still suffered from at least one symptom, after a year it was only 49 percent of the participants. As for shortness of breath, however, the proportion of those affected increased from 26 percent after six months to 30 percent after twelve months. In particular, patients who were so seriously ill that they had to be artificially ventilated during their hospital stay were often still short of breath after a year – in 39 percent of cases. Of the less seriously ill patients, on the other hand, only one in four reported shortness of breath after one year.
Lung function tests after one year showed that the oxygen transfer from the lungs to the bloodstream was reduced in 35.7 percent of the examined – with no improvement compared to the six-month examination. Chest CT images after six months showed abnormal changes in the lungs of 186 of 353 examined. More than half of those affected still had abnormalities after twelve months.
Mental problems in those who have recovered
Mental illnesses such as depression and anxiety were also more common in the group of former Covid 19 patients than in the control group, in 26 percent compared to five percent. The researchers recorded a slight increase compared to the six-month study. “We still don’t fully understand why psychiatric symptoms in COVID-19 survivors are slightly more common after one year than after six months,” says Cao’s colleague Xiaoying Gu. “They could be caused by a biological process related to the viral infection itself or to the body’s immune response to the infection. But they could also be related to reduced social contacts, loneliness, incomplete restoration of physical health or the loss of a job as a result of the illness. “
The researchers also surveyed the employment status of those who had recovered. About half of the participants were retirees. Of the remainder, 88 percent returned to their original job within a year and 76 percent worked at the same level as before they became ill. The most important reason not to return to the previous job was decreased physical performance.
More research needed
Since the study only includes those who have recovered from a single hospital, the researchers point out that the results may not be transferable to other Covid-19 patients. There is still a lack of reliable data, particularly for people who are less ill and who have not been treated in hospital.
In an editorial to the study, which was also published in the journal Lancet, the authors write: “Scientists and medical professionals must work together to research the mechanism and pathogenesis of Long Covid, to better assess the global and regional burden of disease, to better determine who most at risk is understanding how vaccines could affect the disease and finding effective treatments through randomized controlled trials. ”It is also important that health systems provide both treatment and rehabilitation. “This is a challenge that the entire health community must face.”
Source: Lixue Huang (Capital Medical University, Beijing, China) et al., Lancet, doi: 10.1016 / S0140-6736 (21) 01755-4