More than three quarters of those who have contracted COVID-19 still have some form of symptom six months later according to a recent study published in The Lancet.

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“Because COVID-19 is such a new disease, we are only beginning to understand some of its long-term effects on patients’ health.” said Professor Bin Cao, from the National Center for Respiratory Medicine, China-Japan Friendship Hospital and Capital Medical University. “Our analysis indicates that most patients continue to live with at least some of the effects of the virus after leaving hospital, and highlights a need for post-discharge care, particularly for those who experience severe infections. 

“Our work also underscores the importance of conducting longer follow-up studies in larger populations in order to understand the full spectrum of effects that COVID-19 can have on people.”

The study was conducted among those first affected by the disease, with 1,733 COVID-19 patients who were discharged from Jin Yin-tan Hospital in Wuhan – the capital city of China’s Hubei province where the COVID-19 pandemic is believed to have originated – included. Questionnaires were conducted on individuals involved with the study, as well as physical examinations, lab tests and endurance tests that had the individuals monitored while walking over a period of six minutes.

The results found 76 percent of patients reported at least one ongoing symptom. Fatigue or muscle weakness was reported by 63 percent; 26 percent reported sleep difficulties; and 23 percent experienced anxiety or depression.

A Lancet commentary published in May last year presented initial results that indicated the potential for severe long-term implications in those affected by COVID-19. Chest CT scans — again from individuals from Wuhan — showed bilateral ground glass opacities following recovery from the virus. Ground glass opacities refers to unspecified murky areas within CT scans of the lungs, often corresponding to fluid secretion or damaged tissue.

Symptoms such as fatigue and muscle weakness in the recent study make sense when put into the context of ongoing issues developed in the lungs. Previous studies that have indicated an ongoing reduction in lung airflow capacity may be further reinforced by the new results.

Other symptoms included impaired kidney function, as well as an almost fifty percent reduction in antibody levels six months following infection, raising concerns of the potential for reinfection.

Symptoms involving mental health are more difficult to place into context. Some accounts suggest that in some with more severe infections, mental faculties may be impaired for some time following infection. As such, symptoms such as depression and anxiety may be directly related to the COVID-19 infection or may simply be reactive, brought about by the period of infection or the prevailing physical symptoms.

Other scientists have commented on the results of the study. Monica Cortinovis, Norberto Perico, and Giuseppe Remuzzi, from the Istituto di Ricerche Farmacologiche Mario Negri (Mario Negri Institute for Pharmacological Research) in Italy, noted that 

“Even though the study offers a comprehensive clinical picture of the aftermath of COVID-19 in hospitalised patients, only four percent were admitted to an intensive care unit (ICU), rendering the information about the long-term consequences in this particular cohort inconclusive. 

“Nonetheless, previous research on patient outcomes after ICU stays suggests that several COVID-19 patients who were critically ill while hospitalised will subsequently face impairments regarding their cognitive and mental health and/or physical function far beyond their hospital discharge.”

The study underlines one key message: as a new disease we simply do not know all the answers regarding COVID-19 — though we may be dealing with its impact for the foreseeable future. For upwards of three quarters of all those who contract the disease (including those who do not require intensive care) to have chronic symptoms lasting more than six months is a concerning fact. For this to be the case in a disease that has affected more than ninety million people even more so.

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