Wuhan Covid-19 study finds some patients still have health problems after a year
A study of Covid-19 patients in the city where the pandemic began has found that some continue to battle with health impairments a year after contracting the virus.
Women who were hospitalised in Wuhan, China, were more prone than men to fatigue, lung problems and muscle weakness.
The study, which assessed 1,276 patients hospitalised between January and May 2020 has been published in The Lancet.
Findings show that around one in three people still have shortness of breath and lung impairments persisted in some patients, especially those who experienced the most severe illness.
Overall, Covid-19 survivors were less healthy than people from the wider community who had not been infected with the virus.
Prof Bin Cao, from the National Centre for Respiratory Medicine, China-Japan Friendship Hospital, said: “Our study is the largest to date to assess the health outcomes of hospitalised Covid-19 survivors after 12 months of becoming ill.
“While most had made a good recovery, health problems persisted in some patients, especially those who had been critically ill during their hospital stay.
“Our findings suggest that recovery for some patients will take longer than one year, and this should be taken into account when planning delivery of healthcare services post-pandemic.”
The study found that long-term effects of Covid-19 have been widely reported and are an increasing concern.
A previous study by the same researchers reported outcomes from 1,733 hospitalised Covid-19 survivors after six months found that around three-quarters had persistent health problems.
Our findings suggest that recovery for some patients will take longer than a one year, and this should be taken into account when planning delivery of healthcare services post-pandemicProfessor Bin Cao National Center for Respiratory Medicine, China-Japan Friendship Hospital, China
The new study includes 1,276 patients from the same cohort to assess their health status after 12 months.
According to The Lancet, patients underwent detailed health checks at six and 12 months to assess ongoing symptoms and health-related quality of life.
Fatigue or muscle weakness were the most commonly reported symptoms, with around half of patients experiencing them at six months, falling to one in five patients at a year.
Almost one third of patients reported experiencing shortness of breath at 12 months, which was slightly higher than at six months.
This was more prevalent in patients who had been the most severely ill and had been on a ventilator during their time in hospital, compared to those who had not required oxygen treatment.
At the six-month check, 349 study participants underwent a lung function test and 244 of those patients completed the same test at 12 months.
The proportion of patients experiencing diffusion impairment did not improve from six months to 12 months and this was seen across all groups regardless of how ill they had been when hospitalised.
Also at the six-month check, 353 study participants were given a chest CAT scan. Around half of them showed lung abnormalities on their scan and were offered a repeat scan at 12 months.
Of the 118 patients who completed the scan at 12 months, the proportion of patients with abnormalities decreased substantially across all groups but was still high, particularly in the most critically ill group
At the 12-month check, 1,252 of the patients reported their work status before and after being discharged from hospital.
Of the patients who had been employed full or part-time before falling ill, the majority had returned to their original job and most had returned to their pre-Covid-19 level of work within 12 months.
Among those who did not return to their original work, 32% cited decreased physical function, 25% were unwilling to do their previous role and 18% were unemployed.
Compared with men, women were 1.4 times more likely to report fatigue or muscle weakness, twice as likely to report anxiety or depression and almost three times as likely to have lung diffusion impairment after 12 months.
People who had been treated with corticosteroids during the acute phase of their illness were 1.5 times as likely to experience fatigue or muscle weakness after 12 months, compared to those who had not been treated with corticosteroids.
When compared with people of the same age, sex and pre-existing health problems who had not had Covid-19, hospitalised survivors were more likely to experience pain or discomfort at 12 months.
They were also more likely to experience mobility problems.
The study also found that mental health is an important consideration in the recovery of Covid-19 patients.
Slightly more patients experienced anxiety or depression at one year than at six months.
Xiaoying Gu, one of the study’s authors, said: “We do not yet fully understand why psychiatric symptoms are slightly more common at one year than at six months in Covid-19 survivors.
“These could be caused by a biological process linked to the virus infection itself, or the body’s immune response to it.
“Or they could be linked to reduced social contact, loneliness, incomplete recovery of physical health or loss of employment associated with illness. Large, long-term studies of Covid-19 survivors are needed so that we can better understand the long term physical and mental health consequences of Covid-19.”