Long Covid Alert: Wuhan Study Finds Health Problems In Recovered Patients Even After A Year

Study published in The Lancet says health systems must be prepared to offer long-term support for patients who contracted Covid infection.

A worker disinfects a primary school as new semester approaches on August 25, 2021 in Wuhan, Hubei Province of China. | Getty

New Delhi: Around half of the patients who were hospitalised with Covid-19 diagnosis last year still suffer from at least one symptom, even after a year of recovery, a recent study has found.

The study published in The Lancet was conducted on 1,276 patients in Wuhan, China, where the first Covid case was recorded. 

In around 35.7% of the patients whose illness was most severe, symptoms like shortness of breath and lung damages persisted, the study says. The flow of oxygen from their lungs to the bloodstream was reduced. This was indicative of the fact that the health of recovered Covid-19 patients was worse than those who were never infected with SARS-CoV-2. 

Professor Bin Chao from the National Center for Respiratory Medicine, China-Japan Friendship Hospital, China, says this was the largest study that assessed the health conditions of hospitalised Covid-19 patients after 12 months of being infected with the virus. He says they found the critically ill patients to suffer the most, even after a year. He also explained that healthcare delivery plans, after the pandemic is over, should focus on the findings of this study so that such cases could be minimised. 

A Lancet editorial related to this report explains that Long Covid is a big medical challenge, and that it results in economic losses and reduces productivity of people. Millions of people around the globe are affected due to persistent symptoms like brain fog, breathlessness, fatigue, depression, among others, it says, adding it is of utmost importance to understand this disease properly. 

The patients assessed for the study were all discharged between January 7 and May 29, 2020. They were made to undergo health checks at six and 12 months from the date when they first showed Covid-19 symptoms. Their conditions were studied and endurance levels assessed with the help of questionnaires, six-minute walking tests, lab tests and physical examinations.

What The Study Found

At six months, 831 out of 1,227 (68%) patients were still suffering from at least one Covid-19 symptom, and at 12 months, the numbers dropped to 620 out of 1272 (49%), irrespective of the severity of the disease. 

As much as 53% of the patients were still suffering from symptoms like fatigue or muscle weakness at six months, and the percentage dropped to 20% at the end of 12 months. However, the percentage of patients facing shortness of breath increased from 26% at six months to 30% at 12 months. Around 25% of the patients, or 79 out of 317 patients, did not require oxygen treatment, and compared to them, 39% of the patients (37/94), who required ventilator support during their treatment, suffered more from shortness of breath. 

Not much improvement was seen in the lung functioning of the patients, from six months to 12 months. As many as 244 out of the 349 patients had poor lung functioning even after a year. 

Also, 353 patients were made to undergo a CT scan, at both six months and 12 months, and 52.7% of them showed lung abnormalities at the end of 12 months. 

The median or average age of the patients included in the study is 57 years. The study found that around 53% of the patients had retired before contracting the disease. Of the 479 patients who were employed, around 88% returned to work after their health improved, and around 76% (321/422) were able to return to their pre-Covid-19 level of work. 

The likeliness of women reporting fatigue or muscle weakness was 1.4 times the probability of men reporting the same. Meanwhile, the probabilities of women reporting anxiety or depression, and lung diffusion impairment, were two times and three times respectively, the probabilities of men reporting these symptoms. 

Comparison With The ‘Wider Community’ 

The study made a comparison between people who did not suffer from Covid-19 but had pre-existing health problems, and the hospitalised survivors. The people who didn't suffer from the disease but had some health problems from before were classified as the wider community. All the participants who were compared were of the same age and sex. It was found that at the end of 12 months, the hospitalised survivors had higher chances of suffering from pain, discomfort and mobility problems.

According to Lixue Huang from Capital Medical University and China-Japan Friendship Hospital, China, who is also a co-author of the study, the comparison between those who had pre-existing symptoms but didn't suffer from Covid-19, and those who suffered from the disease, helped the researchers understand how SARS-CoV-2 affected the lives of those infected by it. 

Comparisons about anxiety and depression were made between the wider community and the hospitalised patients, and it was found that the percentage of the latter group of participants suffering from anxiety and depression increased from 23% at six months to 26% at 12 months, while in the wider community, the percentage of people suffering from these problems decreased over a period of six months.

Another author of the study, Xiaoying Gu, explained that reduced social contact, loneliness, incomplete recovery of physical health and loss of employment could be accounted for the increase in the prevalence of anxiety and depression in hospitalised patients at the end of 12 months. 

The authors said they conducted the study in a single hospital, and as an additional study, considered a few patients (94/1276) from the intensive care unit.