Long Covid | Serious patients show some symptom for at least 2 yrs: Lancet study

At least half of the people who were admitted to a hospital due to Covid-19 suffer from one or more symptoms two years after the infection, according to a study published in The Lancet Respiratory Medicine on Tuesday, the longest such follow-up study done till date.

The study, based on patients in China where the coronavirus first caused the largest outbreak in early 2020, adds to a growing body of evidence around Long Covid, a set of conditions that continue to persist even after someone has cleared the virus.

“Our findings indicate that for a certain proportion of hospitalised Covid-19 survivors, while they may have cleared the initial infection, more than two years is needed to recover fully. Ongoing follow-up of Covid-19 survivors, particularly those with symptoms of long Covid, is essential to understand the longer course of the illness, as is further exploration of the benefits of rehabilitation programmes for recovery,” said professor Bin Cao of the China-Japan Friendship Hospital in China, and the lead author of the study, 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,” the scientist added.

While physical and mental health generally improved over time, the researchers found Covid-19 patients tended to have poorer health and quality of life than the general population. The persisting symptoms typically included one or more of the following: fatigue, shortness of breath, and sleep difficulties.

The authors analysed the long-term health outcomes of hospitalised Covid-19 survivors as well as specific health impacts of Long Covid. The study included 1,192 participants with acute Covid-19 admitted to the Jin Yin-tan Hospital in Wuhan between January 7 and May 29, 2020, at six months, 12 months, and two years, according to the study.

Six months after initially falling ill, 68% of participants reported at least one Long Covid symptom. By two years after infection, the reported prevalence of symptoms had fallen to 55%. Fatigue or muscle weakness were most often reported, and fell from 52% at six months to 30% at two years.

Regardless of the severity of their initial illness, 89% of participants returned to their original work at two years.

Two years after initially falling ill, patients with Covid-19 are generally in poorer health than the general population, with 31% reporting fatigue or muscle weakness and the same percentage reporting sleep difficulties.

Long Covid participants also more reported problems with their mobility (5%) or activity levels (4%) than those without long Covid (1% and 2% respectively).

“…the burden of symptomatic sequelae remained fairly high… The study findings indicate that there is an urgent need to explore the pathogenesis of long Covid and develop effective interventions to reduce the risk of long Covid..,” said the authors.

Doctors in India said they too are seeing similar trends in Covid recovered persons.

“Even after a year-and-a-half, I see Covid-recovered persons in my OPD with complaints of fatigue, muscle weakness, joint pain, disturbed sleep, anxiety, gastrointestinal issues etc. The symptoms are more severe for those who have had lung involvement. We saw the same pattern during 2012 MERS outbreak, wherein even after 3 years 40% of the recovered persons still were fatigued,” said Dr GC Khilnani, former head, department of pulmonary medicine, All India Institute of Medical Sciences, Delhi.

The authors, however, acknowledged limitations to their study, which among other things pointed that it being a single centre study from early in the pandemic, the findings may not directly extend to the long-term health outcomes of patients infected with later variants.