Most inpatients with COVID have not fully recovered 6 months after discharge

Chinese researchers found that three-quarters of patients previously hospitalized for COVID-19 continued to report at least one symptom after six months.

Fatigue or weakness was by far the most common symptom (63%), followed by sleep disorders (26%), and 23% of patients said they had anxiety or depression. Dr. Bin Cao of Japan Friendship Hospital reported. Beijing and colleagues, Lancet..

“Our analysis shows that most patients survive with at least some of the effects of the virus after discharge, and the need for post-discharge care, especially for patients experiencing severe infections. Is highlighted, “Cao said in a statement. “Our study also emphasizes the importance of conducting longer follow-up studies in larger populations to understand the full extent of the potential impact of COVID-19 on people. . “

This is the largest cohort with the longest follow-up ever for adult patients admitted with COVID-19, as researchers around the world are investigating the so-called “long COVID” phenomenon.Other recent studies focused on Long-term neurological symptoms of Italian patients, the same as Lung abnormalities In a British patient.

“No studies have reported symptoms of extrapulmonary organs that may persist after acute injury or may develop newly after discharge,” Cao et al. Said.

They examined data from 1,733 patients who were discharged from a hospital in Wuhan from January 7th to May 29th and lasted from June 16th to September 3rd. They had a physical examination, were interviewed about their quality of life, and had a 6-minute walk test. Blood sampling. Some patients also underwent lung function tests and high-resolution chest CT.

The average age of patients was 57 years, with 52% being male. The median follow-up period after onset of symptoms was 186 days. Almost 30% of patients had hypertension, 12% had diabetes, and 7% had cardiovascular disease. Almost 70% of patients needed oxygen during hospitalization and 4% were admitted to the ICU. The median length of stay was 14 days.

Researchers used a seven-step severity scale from no hospitalization to hospitalization requiring intubation or extracorporeal membrane oxygenation.

A little less than 30% of the most severely ill patients (stages 5-6 on the scale) had a median 6-minute walk distance below the lower limit of the normal range at follow-up.

Of the 349 participants who completed lung function tests, 56% of the most severely ill patients had pulmonary diffusion disorders. The authors also state that more severely ill patients are at increased risk of fatigue, weakness, anxiety and depression.

In addition, 13% of patients with normal renal function showed reduced estimated spherical filtration rate (eGFR) at follow-up among 822 patients with available eGFR data.

But Ancillary editorial Giuseppe Remuzzi, MD and colleagues from Istituto di Ricerche Farmacologiche Mario Negri in Bergamo, Italy, said the GFR estimation equation “does not allow a healthy assessment of renal function and can be overestimated or underestimated compared to measurements He warned about these findings. GFR. “

On the other hand, they pointed out that deep vein thrombosis was not diagnosed at follow-up, given how many patients developed this condition during hospitalization, and called it a “promising finding.”

The editors pointed out that only 4% of the cohort were admitted to the ICU and could not draw meaningful conclusions about the most severely ill patients.

Other restrictions pointed out by Bao and colleagues include the lack of baseline lung function and 6-minute walking distance, whether new symptoms after COVID-19 persist or worsen after recovery, or after discharge. This includes not being stratified to determine if it will occur. Similarly, mild cases were not included in the study.

Remuzzi and colleagues reiterated the author’s call for longer follow-up in larger groups.

“These studies provide a better understanding of the natural history of COVID-19 sequelae and the factors or mediators involved, and the effectiveness of therapeutic interventions to mitigate the long-term effects of COVID-19 on multiple organs and tissues. Allows you to evaluate. “Remuzzi and colleagues wrote.