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After a year, only 1 in 4 hospitalized COVID-19 patients feels fully recovered – Who is most at risk?

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The study also highlighted the most prevalent long-term COVID symptoms and the primary risk factors linked to not feeling totally recovered after a year.

A new UK study of over 2,000 patients after hospitalization with COVID-19, presented at this year’s ECCMID 2022 and published in The Lancet Respiratory Medicine, finds that only about one in four patients feel fully recovered a year after receiving COVID-19. 

The scientists discovered that being a woman vs a man (32 percent less likely), being obese (half as likely), and having had mechanical ventilation in the hospital (58 percent less likely) were all linked to a reduced likelihood of feeling fully recovered after a year. Fatigue, muscle discomfort, physical slowness, poor sleep, and dyspnea were the most common long-COVID symptoms.

The data for this investigation came from the post-hospitalization COVID-19 (PHOSP-COVID) project, which looked at persons (aged 18 and up) who had been hospitalized with COVID-19 and then discharged across the UK. Patients from 39 NHS hospitals in the United Kingdom were enrolled in the study, and they agreed to five-month and one-year follow-up examinations in addition to their clinical care. At 5 months and 1 year after hospital discharge, patient-reported outcome measures, physical performance, and organ function were used to assess recovery. During the five-month visit, the researchers drew blood samples from the participants to test for the presence of several inflammatory proteins.

A total of 2320 people were examined 5 months after being discharged from the hospital between March 7, 2020, and April 18, 2021, with 807 (33 percent) of them completing both the 5-month and 1-year visits at the time of analysis (and the study is ongoing). The average age of the 807 patients was 59 years, with 279 (36 percent) of them being women and 28 percent requiring invasive mechanical ventilation. Between 5 months (501 [26 percent] in 1965) and 1 year, the proportion of patients reporting full recovery was similar (232 [29 percent ] of 804).

The authors identified four groups or ‘clusters’ of symptom severity at five months in an earlier article from this study, which were validated by this present analysis at one year.  There was enough data on 1636 of the 2320 participants to assign them to a cluster: 319 (20 percent) had very severe physical and mental health impairment, 493 (30 percent) had severe physical and mental health impairment, 179 (11 percent), moderate physical health impairment with cognitive impairment, and 645 (39 percent) had mild mental and physical health impairment. Obesity, less exercise ability, more symptoms, and higher levels of the inflammatory biomarker C-reactive protein were all linked to the more severe clusters. When compared to the mild cluster, levels of the inflammatory biomarker interleukin-6 (IL-6) were greater in both the very severe and moderate with cognitive impairment clusters.

The authors say: “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.”

They found “female sex and obesity were major risk factors for not recovering at 1 year… In our clusters, female sex and obesity were also associated with more severe ongoing health impairments including reduced exercise performance and health-related quality of life at 1 year, potentially highlighting a group that might need higher intensity interventions such as supervised rehabilitation.”

Image Credit: Getty

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