- Three-quarters of patients with COVID-19 hospitalized in Wuhan, China, had at least one persistent symptom six months after falling ill, a new study found.
- About 63% of patients reported fatigue or muscle weakness – the most common symptom in the long run.
- Doctors say that long-term cases of COVID-19 resemble chronic fatigue syndrome, a disease that can last for several years or more.
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Tens of millions of people have already suffered from the coronavirus worldwide. But there are still doubts about what recovery really means. A new study shows the alarming fate that hospitalized patients face six months after their illness.
A study published on Friday in The Lancet found that 76% of COVID-19 patients who were hospitalized in Wuhan, China, still had at least one symptom six months after becoming ill. The study followed 1,733 adult patients diagnosed with COVID-19 between January and May 2020.
The researchers followed the patients from June to September, carrying out laboratory tests, physical examinations, pulmonary function tests and personal interviews.
About 63% of patients in the study reported muscle fatigue or weakness after six months – the most common long-term symptom seen. Another 26% of patients said they had difficulty sleeping, while 23% said they had experienced anxiety or depression since they fell ill.
The researchers said that, as far as they know, this study is the largest to date to assess the long-term symptoms of patients with COVID-19 previously hospitalized. It also has the longest follow-up duration of any research on the topic to date.
“Because COVID-19 is such a new disease, we are just beginning to understand some of its long-term effects on patients’ health,” said Bin Cao, one of the study’s authors, in a statement. “Our analysis indicates that the majority of patients continue to live with at least some of the effects of the virus after hospital discharge and highlights the need for post-discharge care, especially for those with severe infections.”
‘A forgotten group’
A COVID-19 patient leaves Juarez Hospital to go to his home in Mexico City, Mexico, on July 27, 2020.
Edgard Garrido / Reuters
Of the 390 patients in the study who took a lung function test about six months after diagnosis, those who received supplemental oxygen or were placed on a ventilator – people with the most serious infections – were more likely to have persistent reduced lung function. They also had more difficulty walking than patients who had milder cases.
About 822 patients in the study had normal kidney function while in the hospital, but 13% of them had reduced kidney function six months later.
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Since the new study examined only hospitalized patients, their findings may not be generalizable to everyone who has long-term symptoms.
Until recently, these individuals were “a forgotten group,” Dr. Steven Deeks, a professor of medicine at the University of California, San Francisco, told Business Insider.
“It all has to do with the treatment of acute illness, which is understandable,” he said. “But now there is widespread acceptance that there are these long-term complications, which can be disabling.”
Doctors have not yet come up with a unified term for the set of long-lasting symptoms of COVID-19, but some researchers refer to it as “long-COVID”. Many patients, however, have defined themselves as “long-haulers”. Deeks said he prefers the term “post-acute COVID syndrome”.
It is not yet known how many people in total have this affliction. An August study by UK researchers estimated that one in 10 coronavirus patients experienced prolonged illness. A study by King’s College London, which is still awaiting peer review, found that nearly 100 out of 4,000 patients with coronavirus did not recover after 12 weeks of illness.
Long-term symptoms may resemble chronic fatigue syndrome
The new study contributes to a growing body of research, suggesting that fatigue is a common symptom in long-distance cases. In the King’s College study, almost 98% of patients who were still sick after four weeks said they suffered from fatigue.
Some patients also report feeling weak or hazy after a lot of physical activity – a characteristic of chronic fatigue syndrome, which is a disease that can last for several years or more.
Sandra Cabreras, 57, rides an exercise bike to strengthen muscle tone while suffering from post-COVID fatigue.
Marco Di Lauro / Getty Images
Many patients who have contracted SARS have dealt with similar long-term symptoms, a useful clue, as SARS and the new coronavirus share about 80% of their genetic codes. A follow-up study of SARS patients in Hong Kong found that 27% met the clinical criteria for chronic fatigue syndrome four years after the onset of the disease. And a study of 109 SARS patients in Toronto found that more than half had not returned to work due to persistent fatigue and weakness a year after they were discharged from the ICU.
This ended up affecting the mental health of SARS patients. More than 40% of participants in the Hong Kong study had active psychiatric illnesses, including post-traumatic stress disorder and depression. Only 3% of them had a history of these diseases before being diagnosed with SARS.
Mental health problems, Deeks said, are a “big part of the pack” when it comes to post-acute COVID syndrome.
He suspects that the new condition is different from chronic fatigue syndrome, although there is likely to be some overlap. It could take years of research for scientists to understand why certain symptoms of the coronavirus persist, he added.
“There will be a series of purely observational studies: here is what we saw in our clinic. Here is what we saw in this group of hospitals,” said Deeks. “That will be useful, but there will be no control arms.”
An ideal study, Deeks said, would involve large groups of healthy people and track them over time. Among the group that ends up receiving COVID-19, researchers can then analyze the differences between patients whose symptoms persisted and those who did not.
“It could take years,” added Deeks. “And in the days of COVID, it’s been decades.”