The 32nd European Congress of Clinical Microbiology and Infectious Diseases (ECCMID2022) 2022 was held in Lisbon, Portugal from 23 to 26 April 2022. At the conference, the research team led by Professor Christopher Brightling, Dr Rachael Evans, Professor Louise Wain of the National Institute of Health, Leicester Biomedical Research Centre, University of Leicester, UK presented their findings. They surveyed 2,000 hospitalized patients with COVID-19 and found that only about a quarter of those achieved full recovery after 1 year.
The research team published the findings in The Lancet Respiratory Medicine, titled "Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in." the UK: prospective observational study”。
https://doi.org/10.1016/S2213-2600(22)00127-8
The researchers found that women, obese, and patients who had worn a ventilator while hospitalized were unlikely to achieve a full recovery after 1 year. The most common long-term sequelae of COVID-19 are fatigue, muscle pain, slow movement, poor sleep quality and difficulty breathing.
The data used in the study is derived from the New Coronavirus Disease Post-Discharge Survey (PHOSP-COVID), which is all adult (18 years and older) patients in the UK who are hospitalized for COVID-19 and then discharged. Patients from 39 hospitals in the UK National Health Service (NHS) were also included and agreed to undergo follow-up assessments from 5 months to 1 year in addition to clinical care. The degree of recovery was measured by patient reported outcome (PRO) measures, physical activity, and organ function after 5 months to 1 year of discharge. The researchers also took blood samples from patients who were followed up for 5 months to analyze the presence of various inflammatory proteins.
A total of 2,320 patients were discharged between 7 March 2020 and 18 April 2021, of which 807 (33%) achieved full recovery during follow-up evaluations at 5 months and 1 year later (the study is still ongoing). The average age of the 807 patients was 59 years, of which 273 (36%) were female patients, while 28% had worn invasive ventilators. Among patients followed up at 5 months and 1 year, the proportion of patients who recovered fully was very similar, at 26% (501 out of 1965) and 29% (232 out of 804), respectively.
An early report of the study showed that the researchers divided patients into four groups based on the severity of their symptoms in a follow-up of 5 months later. In the new study a year later, the severity of these symptoms was confirmed. Of the 2320 patients, 1636 had sufficient data to group: 319 (20%) had extremely serious impairments in physical and mental health, 493 (30%) had severe physical and mental health impairments, 179 (11%) had moderate physical impairment with cognitive impairment, and 645 (39%) had mild impairments in their physical and mental health. Obesity, decreased mobility, a large number of sequelae, and elevated levels of the inflammatory biomarker C-reactive protein (CRP) all appear in more severe groups. Levels of the inflammatory biomarker interleukin-6 (IL-6) were relatively higher in both groups with extremely severe impairment and moderate impairment with cognitive impairment compared to the mildly impaired group.
Dr Evans said: "In our study, patients aged 5 months to 1 year after discharge were remarkably significant in terms of limited recovery in terms of symptoms, mental health, athletic ability, organ damage and quality of life. ”
She added: "We found that women and obese patients recovered relatively poorly after 1 year. In our grouping, women and obese patients always suffer from more severe ongoing impairments, including slow mobility and decreased quality of life, which also potentially highlights the need for higher intensity interventions in this group, such as supervised rehabilitation. ”
There is no treatment specifically for the long-term sequelae of COVID-19, Professor Wain said: "Our data show that there is an urgent need for effective interventions. For both groups with extremely severe and moderate impairment with cognitive impairment, we found that long-term systemic inflammation may indicate that they respond to anti-inflammatory strategies. The physical and psychological damage to patients with long-term COVID-19 shows that we not only need to combine their physical and mental health treatments, including assessment and intervention, but also the exchange of information between medical personnel to improve patient care. The finding also suggests that we need complex interventions for both physical and psychological impairment to alleviate symptoms. Moreover, it is necessary to develop specific treatments for PTSD. ”
Professor Brightling concluded: "Our study highlights that there is now an urgent need for medical services to support this large and rapidly growing patient population with a large number of symptoms, including slow mobility and a significant decline in quality of life 1 year after discharge. Without effective treatment, the long-term sequelae of COVID-19 could become a highly prevalent new long-term disease. Our research also provides a theoretical basis for the treatment of long-term sequelae of the new crown, using precision medicine methods to carry out targeted treatment for individual patients, so that patients can return to normal healthy life. ”
Resources:
https://medicalxpress.com/news/2022-04-patients-hospitalization-covid-fully-recovered.html
Source: Translational Medicine Network
![Oral experience of Australian Delta recoverers: The new crown is like a small cold, the key is to strengthen immunity[fig]](data:image/gif;base64,R0lGODlhAQABAIAAAP///wAAACwAAAAAAQABAAACAkQBADs=)