Hospitalised Covid patients have poorer health, quality of life than others, shows study

Two years after infection with Covid-19, half of the patients who were admitted to hospital still have at least one symptom, says a new study that followed close to 1,200 Chinese individuals treated at a hospital in Wuhan, the ground zero of the pandemic in its initial days.

While physical and mental health generally improved over time, the study suggests Covid-19 patients still tend to have poorer health and quality of life than the general population.

This is especially the case for participants with long Covid, who typically still have at least one symptom including fatigue, shortness of breath, and sleep difficulties two years after initially falling ill.

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The long-term health impacts of Covid-19 have remained largely unknown, as the longest follow-up studies to date have spanned around one year.

The lack of pre-Covid health status baselines and comparisons with the general population in most studies have also made it difficult to determine how well patients with Covid-19 have recovered.

Despite such ambiguity, long Covid has clearly emerged as a public health concern that not only disrupts the health care of people living with non-communicable diseases but likely also increases the burden of several other diseases.

The adverse effects range from fatigue and difficulty in concentrating, to neurological and neuropsychiatric symptoms, respiratory and cardiovascular problems, and metabolic diseases.

A proportion of hospitalised Covid survivors at Wuhan needed more than two years to recover fully even though they had cleared the initial infection within days.

Six months after initially falling ill, 68 per cent of participants reported at least one long Covid symptom. By two years after infection, the reports of symptoms had fallen to 55 per cent.

Fatigue or muscle weakness were the symptoms most often reported. Its prevalence fell from 52 per cent at six months to 30 per cent at two years.

Mental health assessments found 13 per cent displayed symptoms of anxiety and 11 per cent displayed symptoms of depression. On the positive side, 89 per cent returned to their work after two years regardless of these symptoms.

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“Ongoing follow-up of Covid-19 survivors, particularly those with symptoms of long Covid, is essential to understand the longer course of the illness,” lead investigator Bin Cao from the China-Japan Friendship Hospital, China says in a statement.

“There is a clear need to provide continued support to a significant proportion of people who’ve had Covid-19, and to understand how vaccines, emerging treatments, and variants affect long-term health outcomes.”

Published in the Lancet Respiratory Medicine, the analysis is the longest follow-up study to date in which the researchers evaluated the health of 1,192 participants with acute Covid-19 treated at Jin Yin-tan Hospital in Wuhan between January 7 and May 29 2020, at six months, 12 months, and two years.

Fatigue, shortness of breath, gut/digestive issues, fluctuation of blood pressure, shooting up of blood sugar, menstrual abnormalities and sleep disruption are the common symptoms of long Covid,” said Lancelot Pinto, a senior doctor at PD Hinduja hospital, Mumbai. “In a small fraction of individuals, these symptoms are highly disruptive, although for the majority they do seem to get better with time.”

“Given India's population and the number of individuals who have been infected over the past two years, medically significant long Covid symptoms warranting treatment appears to be thankfully rare,” he told DH.

In the Lancet study, the assessments involved a six-minute walking test, laboratory tests, and questionnaires on symptoms, mental health, health-related quality of life, if they had returned to work and health-care use after discharge.

The negative effects on quality of life, exercise capacity, mental health, and healthcare use were determined by comparing participants with and without long Covid symptoms. Health outcomes at two years were determined using age, sex, and comorbidities matched control group of people in the general population with no history of Covid infection.

The Lancet study included individuals who were hospitalized and the data could not be extrapolated to all individuals with Covid-19, explained Pinto.