Two years after being hospitalized with COVID-19, survivors of the virus are still not at the same health status as those who never got it, according to a new study.
And half of those patients are still suffering from at least one virus-related symptom, suggesting long COVID could end up affecting patients even longer than expected.
The study, published last week in the scientific journal The Lancet Respiratory Medicine, follows 1,192 patients hospitalized with COVID-19 at Jin Yin-tan Hospital in Wuhan, China, between early January 2020 and late May 2020.
Because the research focuses on participants who became infected from the very beginning of the pandemic, it represents some of the longest data we have on the ongoing impact of COVID-19 and sheds more light on how this pandemic affects large segments of the population with persistent problems could burden for years.
“Our results show that for a certain proportion of hospitalized COVID-19 survivors, it takes more than two years to fully recover from COVID-19, although they may have overcome the original infection,” said Bin Cao, vice president from China-Japan Friendship Hospital and lead author of the study, said in a press release.
“The ongoing follow-up of COVID-19 survivors, particularly those with symptoms of long-term COVID, is essential to understanding the longer course of the disease, as is further research into the benefits of rehabilitation programs for recovery. There is clearly a need to provide ongoing support to a significant subset of people who have had COVID-19 and to understand how vaccines, new treatments and variants are impacting long-term health outcomes.”
This isn’t the first time data from this cohort has been published — researchers released patient results in 2021, examining their health at six months and at one year.
All results were compared to a control group who had never had COVID-19 and whose age, gender and comorbidity were matched to the study’s patient cohort. The median age of the 1,192 patients was 57 years, and there were slightly fewer women at 46 percent.
To assess the patients’ health status at follow-up visits, most of which were conducted in person, the researchers took a physical exam, a six-minute walk test, and laboratory tests, as well as surveys of symptoms, quality of life, mental health, and other aspects of their lives in the Time after they recovered from COVID-19 and were allowed out of the hospital.
In general, the health of those who survive COVID-19 improves over time, the data shows. The percentage of patients who reported experiencing anxiety or depression dropped from 23 percent at six months to 12 percent at two years.
While 14 percent of participants in the six-minute test had difficulty walking at six-month follow-up, that number dropped to eight percent after two years.
After two years, 89 percent of COVID-19 survivors who had a job before the pandemic had returned to that original job.
And in terms of long COVID, about 68 percent of patients had at least one ongoing symptom of COVID-19 at six months, compared to 55 percent two years after contracting the virus.
… BUT COVID-19 HAS A SUSTAINABLE TOLL FOR MANY
The results still suggest that long COVID is affecting large numbers of people for longer than originally expected.
Of the persistent symptoms patients described, the most common were either fatigue or muscle weakness, with 31 percent reporting they experienced one or both. In addition, although patients improved over time, they reported poorer overall mental and physical health than the general population.
“COVID-19 survivors still had more frequent symptoms and more problems with pain or discomfort and anxiety or depression than controls after two years,” the study said.
Just under a third of the participants also reported trouble sleeping two years after contracting COVID-19, compared to just 14 percent of the general population represented by the control group.
COVID-19 survivors were more than four times more likely to report pain or discomfort than controls and more than twice as likely to report anxiety or depression.
And those with long COVID have had to seek medical care more frequently, even two years after contracting the virus. Around 26 percent of those who still had at least one virus-related symptom reported a recent visit to an outpatient clinic, compared to 11 percent of participants without long-COVID.
“To the best of our knowledge, this is the longest longitudinal cohort study of people surviving hospitalization with COVID-19,” the study states. “Long COVID symptoms at two years were associated with reduced quality of life, lower exercise capacity, abnormal mental health, and increased use of health care after discharge.”
Numerous studies have recently been published attempting to quantify the effects of COVID on patients’ bodies and minds. A study published in early May found that the cognitive impact of long COVID was equivalent to aging in 20 years in those assessed six months after their acute illness.
Researchers in this new study say more research will be needed to understand how to combat this.
“The adverse impact on quality of life, physical capacity, and healthcare utilization underscores the importance of studying the pathogenesis of long-standing COVID and promoting research into targeted treatment to treat or alleviate the condition,” the statement said Study.
The study has several limitations, such as the fact that all patients were sourced from a single hospital. Some who were originally part of the cohort did not return for the one-year and second follow-up, and it is unknown whether their presence would have confirmed the long COVID percentages or whether they dropped out because they had no symptoms to report.
Because the study looked at those who contracted COVID-19 early in the pandemic, its findings may not be applicable to those who later contracted variants of the virus, underlining the importance of tracking and investigating COVID -19 in more patients around the world underscores the globe.
“The COVID-19 survivors had not returned to the same health status as the general population two years after acute infection, therefore continuous follow-up is required to characterize the protracted natural history of long-COVID; we plan to conduct annual follow-up in this cohort,” the authors write in the study.
“The value of rehabilitation programs in mitigating the effects of a long COVID and accelerating recovery requires further investigation.”