Study of 2,000 patients after hospitalization with COVID-19 shows only 1 in 4 make a full recovery after 1 year

A new UK study of more than 2,000 patients after being hospitalized with COVID-19 was presented at this year’s European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2022, Lisbon 23-26), and published in Lancet Respiratory Medicine shows that, a year after having COVID-19, only one in four patients feel fully recovered again. The study was led by Professor Christopher Brightling, Dr. Rachel Evans, and Professor Louise Wayne, National Institute for Health Research Leicester Biomedical Research Centre, University of Leicester, UK, and colleagues.

The authors found that being female versus male (32% less likely), obesity (half as likely) and having mechanical ventilation in the hospital (58% less likely) were all associated with a lower chance of complete recovery at one year. , The most common ongoing long-term COVID symptoms were fatigue, muscle aches, being physically slow, poor sleep and breathlessness.

This research used data from the Post-Hospitalization COVID-19 (PHOSP-COVID) Study, which assessed adults (aged 18 years and older) who had been diagnosed with COVID-19 across the UK. He was admitted to the hospital with and was later discharged. Patients from 39 UK National Health Service (NHS) hospitals were included who agreed to a follow-up assessment at five months and 1 year in addition to their clinical care. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge. Researchers also took blood samples from participants at the five-month visit to analyze for the presence of various inflammatory proteins.

A total of 2320 participants who were discharged from hospital between March 7, 2020 and April 18, 2021 were assessed 5 months after discharge and 807 (33%) participants completed both the 5-month and 1-year visits at the time of analysis . (and the study continues). These 807 patients had a mean age of 59 years, 279 (36%) were female and 28% had received invasive mechanical ventilation. The proportion of patients reporting complete recovery was similar at 5 months (501 .) [26%] of 1965) and 1 year (232 .) [29%] of 804).

In an earlier publication of this study* the authors identified four clusters or ‘clusters’ of symptom severity over five months, which were confirmed by this new study at one year. Of the 2320 participants, 1636 had sufficient data to allocate them to a cluster: 319 (20%) had very severe physical and mental health impairment, 493 (30%) had severe physical and mental health impairment, 179 ( 11%) with moderate physical cognitive impairment, and 645 (39%) with mild mental and physical health impairment. Obesity, reduced exercise capacity, greater number of symptoms, and increased levels of the inflammatory biomarker C-reactive protein were associated with the more severe groups. In both the very severe and moderate with cognitive impairment groups, levels of the inflammatory biomarker interleukin-6 (IL-6) were higher than in the mild cluster.

Dr Evans says: “The limited recovery from 5 months to 1 year after hospitalization in our study of symptoms, mental health, exercise capacity, organ loss, and quality of life is striking.”

She adds: “We found that female sex and obesity were the major risk factors for non-recovery at 1 year. In our groups, female sex and obesity were associated with more serious health impairments, including reduced exercise performance and health-related quality of life. were associated. 1 year, potentially uncovering a group that may require high-intensity interventions such as supervised rehabilitation.”

On the paucity of existing treatments for chronic COVID, Professor Wen says: “No specific therapeutics for long-term COVID exist and our data highlight that there is an urgent need for effective interventions. Our treatment of persistent systemic inflammation The findings, particularly in those with very severe and moderate cognitive impairment groups, suggest that these groups may respond to anti-inflammatory strategies. Consensus of the severity of physical and mental health impairment in long-term COVID not only Long highlights the need for closer integration between physical and mental health care for patients with COVID, including assessment and intervention, but also for knowledge transfer between health care professionals to improve patient care. also suggests the need for a treatment that targets both physical and mental health impairments to reduce symptoms. However, specific therapeutic approaches to the management of post-traumatic stress disorder may also be needed.”

Professor Brightling concluded: “Our study highlights the urgent need for health care services to support this large and rapidly growing patient population that presents with a substantial burden of symptoms, with reduced exercise capacity and There is a significant reduction in health-related quality of life after 1 year. Hospital discharge. Without effective treatment, protracted COVID can become a highly prevalent new long-term condition. Our study focuses on individual patient profiles to restore their health. It also provides a rationale for investigating long-term COVID treatment with a precision-medicine approach to target-related quality of life.”

Provided by European Society of Clinical Microbiology and Infectious Diseases