TThree-quarters of Covid-19 patients still have at least one symptom six months after they first became ill, researchers who followed hospital patients in China reported Friday. The new findings suggest that symptoms linger longer and in a higher percentage of patients than previously thought.
The largest and longest analysis to date of recovery after Covid also warns that the antibody level of some patients has dropped sharply, raising concerns that they could re-infect with the coronavirus while awaiting full health recovery.
Nearly two-thirds of patients said they still suffer from fatigue and muscle weakness, the researchers said written in The Lancet. Just over a quarter struggled to sleep, and a little less than a quarter experienced anxiety and depression. In general, more women than men reported persistent symptoms, and people whose disease was worse had poorer lung health. Their median age was 57.
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Earlier studies examining Covid-19’s “long guards” term for people whose well-being does not return after their infections are clear, limited by the time and number of cases. According to a July estimate from the Centers for Disease Control and Prevention, 1 in 3 people still have symptoms that linger for two or three weeks. A survey conducted in the UK concluded in November that 1 in 5 people suffer from symptoms lasting five weeks or longer; 1 in 10 said their problems lasted 12 weeks or longer.
The greater number of patients studied in China, where the pandemic first unfolded, and the greater percentage of people experiencing longer-term problems paint a picture of problems that do not go away.
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‘I am very concerned about the unknown future for these patients’ recovery. “Six months after the onset of symptoms, a large proportion of Covid-19 patients had physical and psychological problems,” co-author Lixue Huang of China-Japan Friendship Hospital and Capital Medical University told STAT. “We still do not know how long it will take before these patients fully recover from Covid-19 and whether complete recovery is possible in all cases.”
Dr David Putrino, who works with patients at the Mount Sinai Center for Post-COVID Care, warned against overreacting to the high percentage of people who report at least one persistent symptom, calling it a mistake to call everyone characterize long carrier. He was not involved in the study.
“Within 76%, there are people who have been transported for a long time, people who have long-term heart damage due to Covid infection, people who have long-term lung damage and kidney damage, and so on.” he said. “And then my suspicion is that a large number of individuals have fairly mild but notable symptoms.”
Shortness of breath or loss of smell six months later is worrying, but it is not the debilitating symptoms he sees in long-term care, Putrino said.
‘It’s not to discount these lived experiences, and not to say it’s not terrible. “It is terrible that people still experience symptoms after six months,” he said. “It really tells us how serious this thing is, but we also need to make sure we report that many of these are very mild symptoms.”
The study, co-author Bin Cao of the National Center for Respiratory Medicine, said in a statement: ‘Emphasizes a need for care after discharge, especially for those experiencing severe infections. Our work also emphasizes the importance of conducting longer follow-up studies in larger populations to understand the full spectrum of effects that COVID-19 may have on humans. ”
For the study, more than 1,700 people treated for Covid-19 Jin Yin-tan Hospital in Wuhan between January and May 2020, answered questions from June to September about their symptoms, gave blood samples and took a six-minute walk test. Nearly 400 also took lung function tests and did CT scans to evaluate their health. Antibodies were tested in the 94 patients who had the previous readings taken when their infections were at their peak.
The levels of neutralizing antibodies – the immune cells that learn from infection to attack the virus when they see it again – have dropped by half in patients with pre- and post-readings, indicating the need for larger studies to to see if reinfection is possibly a serious problem that these patients may be experiencing.
In another complication, 13% of patients who later had normal kidney health when they were in the hospital decreased kidney function, the study found. It is a red flag for people who already have potential risk factors for kidney damage, such as high blood pressure and diabetes.
As expected, people who needed help breathing while in the hospital performed worse with the walking and lung function tests, and CT imaging revealed damaged lungs. Only 4% of the patients in the study were treated in ICUs, so other studies will be needed to draw more conclusions, says an editorial accompanying the Lancet study.
Fred Pelzman, who practices internal medicine in New York and was not involved in the study, said the experiences of patients in China are consistent with what happened in the United States.
“It’s definitely compelling evidence that there are a lot of people with very persistent symptoms,” he said. ‘We see in our clinics for recovery after the Covid that people with cardiomyopathy and neuropathies and cognitive changes and balance changes are entering. It is just a virus that our body has not seen before, that has an enormous inflammatory response, and so it is not surprising that every organ system is upset. ”
Pelzman found the prediction of long-term caregivers difficult to predict, in part because some symptoms may be due to hospitalization, including difficult stays in intensive care units that mean patients have to learn how to walk when they are discharged. He is not surprised by the drop in the antibody level, and says that the body’s immune system is not always alert to stay informed.
“We still do not know if your immunity lasts six months or nine months or a year or ten years,” he said. ‘The interesting thing will be what happens when someone is exposed again. Do they have an increase in the antibodies again? How long does the efficiency last? ‘
Pelzman himself was infected with Covid-19 in March.
“It definitely lingered,” he said. ‘I can get a little windy about Zoom calls. I walk home from work and catch my breath, and some foods still taste funny. But you know, I’m alive and so I’m OK. ‘