HEALTH: Long COVID

As much as 75% of hospital patients still not ‘fully recovered’

| THE INDEPENDENT | There are still many unknowns surrounding COVID-19, the disease caused by SARS-CoV-2, or the duration of persistent symptoms experienced with long COVID.

Researchers in the U.K. recently published a study in The Lancet Respiratory Medicine that followed more than 2,000 hospitalised COVID-19 patients. After having one year to recover following being released from the hospital, roughly only 25% of patients felt like they were completely back to their usual, healthy selves.

Long COVID is the term that describes experiencing COVID-19-related symptoms that last for an extended period of time. Often also called post-COVID syndrome or chronic COVID, people who experience this condition may sometimes be referred to as “long-haulers.”

According to America’s Centers for Disease Control and Prevention (CDC), long COVID refers to “a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19.”

Some symptoms the CDC mentions people with long COVID may experience include: Fatigue, breathing issues, changes in smell or taste, Joint and muscle pain.

Long COVID is prevalent enough that it can be recognized as a disability under the Americans with Disabilities Act.

The study

The researchers started with a group of 2,320 participants who were discharged from the hospital between March 7, 2020, and April 18, 2021. All participants were originally hospitalised due to COVID-19-related illnesses.

The participants followed up with their doctors 5 months after being released from the hospital to have their symptoms assessed.

The patients completed questionnaires about anxiety, depression, fatigue, post-traumatic stress disorder (PTSD), and other health issues. Doctors also tested the participants’ cognitive abilities and pulmonary function.

The researchers assigned participants to four clusters depending on the severity of their physical and mental health symptoms: very severe, severe, moderate, and mild. Half of the participants fell into the very severe and severe clusters.

Of the participants who completed their 5-month follow-up, 807 completed a 1-year follow-up appointment. The majority reported not feeling recovered from COVID-19.

At the 5-month follow-up, 25.5% of the patients reported feeling fully recovered. Of the participants who came back for a 1-year follow-up, 28.9% felt fully recovered, which is an improvement of only roughly 10%.

The researchers found that many of the people who were on mechanical ventilators in the hospital did not feel fully recovered after 1 year.

Additionally, the prevalence of not being back to full health was higher among females and participants with obesity.

“The limited recovery from 5 months to 1 year after hospitalisation in our study across symptoms, mental health, exercise capacity, organ impairment, and quality-of-life is striking,” writes lead author Dr. Rachael Evans, clinical associate professor and honorary consultant respiratory physician at the University of Leicester in the United Kingdom.

She also notes that females and people with obesity may “need higher intensity interventions such as supervised rehabilitation.”

The inflammation link

While the authors write that the mechanisms behind long COVID are unknown, they hypothesise that the hyper inflammation associated with COVID-19 dysregulates the immune system.

“Our findings of persistent systemic inflammation, particularly in those in the very severe and moderate with cognitive impairment clusters, suggest that these groups might respond to anti-inflammatory strategies,” says Professor Louise Wain, one of the study authors and professor in the Department of Health Sciences at the University of Leicester.

Dr. Ziyad Al-Aly, the director of Clinical Epidemiology at the Washington University School of Medicine in St. Louis, Missouri, spoke about long COVID in a Show Me the Science podcast. Of the issues long COVID patients experienced, Dr. Al-Aly noted, at least one is related to inflammation.

“We’re starting now to uncover long-term consequences of COVID-19 that literally will last a lifetime,” Dr. Al-Aly said.

“And then we did work to delve deeper into the cardiovascular manifestations—that’s the heart manifestations, mental health disorders, kidney disorders, and now, most recently, diabetes,” Dr. Al-Aly commented. Inflammation is a known contributing factor in developing type 2 diabetes.

“We think that this is really a consequential problem. It’s going to affect millions and millions of people. And our health systems should be equipped to be able to deal with it,” continued Dr. Al-Aly.

Hard to tell

Dr. Claire Taylor, a physician and neuroscientist who formerly worked for the M.E. Trust in the U.K., spoke with Medical News Today about the study.

“We are severely lacking in tests to objectively show that people have not fully recovered and what is driving that,” she said.

Additionally, Dr. Taylor said she found the inflammatory issues with long COVID patients concerning. However, she expressed hope that the blood tests performed in this study will “open up an avenue for other blood tests to show ongoing inflammation in long COVID patients.”

According to Ugandan medical experts, a significant number of COVID-19 survivors are grappling with the long-term effects of the virus which has affected their productivity and quality of life.

The experts were reacting to the report released by Leicester University that indicated that only a third of COVID-19 survivors got totally healed after one year.

Ugandan medical officers say it is hard to tell that a patient is suffering from long-term effects of COVID-19 because medical workers often do not ask them or the patient may not be willing to disclose that information.

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Source: Medical News Today