Researchers from the China-Japan Friendship Hospital reviewed the records of 1,192 people who had been hospitalized at Jin Yin-tan Hospital in Wuhan, China, and discharged between January 7 and May 29, 2020.
The researchers checked six months, 12 months and two years after the patients were discharged and asked for their subjective assessment of symptoms. Participants were also assessed using more objective medical tests, including lung function tests, CT scans and six-minute walk tests.
In general, participants had poorer health two years later. Those with persistent Covid-19 symptoms listed pain, fatigue, sleep issues and mental health issues. Patients who received higher level respiratory support during their hospitalization had more long-term lung problems than others.
Participants with persistent symptoms also went to the doctor more often than before the pandemic. They had more difficulty exercising and generally reported a poorer quality of life. Most were back at work, but it’s unclear if they were working at the same level as before they fell ill.
Study co-author Dr Bin Cao of the China-Japan Friendship Hospital hopes the research will encourage doctors to ask follow-up questions of their Covid-19 patients, even years after their initial infection.
“There is a clear need to provide ongoing support to a significant proportion of people who have had Covid-19 and to understand how vaccines, emerging treatments and variants affect long-term health outcomes,” Cao said in a statement. Press release.
The study has certain limitations. The researchers did not compare the results to people hospitalized for reasons other than Covid to see if they too had persistent symptoms. They compared the hospitalized group to people in the community who never had Covid-19; this group also had health problems a year later, but this occurred in about half as many people as in the hospitalized group.
Another limitation was that the research involved only one hospital, so the results may not be universal for all hospitalized Covid-19 patients. Earlier in the pandemic, patients were generally kept in hospital longer than they are now, and that could have an effect on how long a person had symptoms. And because the research was done early in the pandemic, it’s unclear whether there would be similar results in people who got sick with later variants of the coronavirus or in those who had been vaccinated.
“The only thing I know I can safely offer long Covid patients is vaccinations,” said Sanghavi, who was not involved in the study. “When we compare unvaccinated patients to vaccinated patients and see the incidence of long Covid symptoms, vaccinated patients have less severe symptoms and less often long Covid.”
“Right now, these patients sometimes seem like an afterthought,” Sanghavi said.
“The study potentially indicates how many people will need help. I don’t know if you’ve tried to get an appointment for a primary care visit, but it potentially takes weeks or even months in many places. And it’s just for a simple wellness checkup – forget the long Covid. It’s a lot longer,” he said.
Sanghavi said more doctors will also need to be trained on how to help people who have had Covid for a long time. “Our healthcare system is unprepared for the type of patient influx this disease will cause,”
Erlandson said so many people want to know about the long Covid that his colleagues didn’t even have to announce the lawsuit; there is a waiting list to enter.
The new research aligns with what staff members are seeing at these long-distance clinics.
“It’s similar to what we’re hearing from patients in the United States saying, that they’re still having symptoms at two years, especially in this first wave of patients in the pandemic. We’ve heard that anecdotally, so it’s always nice to see things published,” said Erlandson, who was not involved in the study. Patients at his clinic also experience similar symptoms, with sleep disturbances and fatigue being the most common.
She stressed that people do not need to be hospitalized for Covid-19 to have persistent symptoms, and she hopes future research will help determine how long non-hospitalized people experience symptoms.
Erlandson also noted that some of the study participants got better after 12 months, but got worse again after two years.
“I think these long studies are interesting to see that it’s not incremental improvement. People kind of fluctuate in terms of improvements,” she said.
Erlandson said she would be curious to know if the participants have improved beyond those two years or if Covid-19 will turn out to be a chronic condition. Doctors can treat some symptoms, but there is no specific treatment for long Covid.
“Unless they have some sort of treatment, I’m concerned it will have a long-term impact on some patients’ disability and function,” she said.