Professor Cao Bin: Paying attention to the long-term impact of COVID-19 in more than 70% of patients has at least one symptom with a clear pathogenesis to improve patient prognosis

Author: Cao Bin, China-Japan Friendship Hospital

As the global pandemic continues, more and more patients survive and are discharged from the hospital, but some patients still have persistent or new symptoms after discharge, their quality of life has decreased significantly, and they have not returned to their pre-COVID-19 health status, which has brought special attention to the long-term impact of COVID-19.

Some patients still have diffuse dysfunction and pulmonary imaging abnormalities To assess the long-term effects of the disease and to clarify the health status of patients after discharge, many countries have completed follow-up studies. At present, the follow-up study evaluation content mainly focuses on symptoms, quality of life, motor ability, lung function and chest imaging, due to the differences in patient admission criteria, follow-up time, assessment content, assessment methods and methods of different follow-up studies, the heterogeneity between studies is large, and the specific abnormal proportions obtained are also different. At present, one of the longest follow-up studies is a longitudinal cohort study from Wuhan, China, which was followed up 1 year after discharge, and found that breathing difficulties and motor ability gradually improved, but some patients still had diffuse dysfunction and lung imaging abnormalities

<h1 class="pgc-h-arrow-right" data-track="8" > more than 70% of patients have at least one symptom</h1>

The author's research team, together with Wuhan Jinyintan Hospital and the Institute of Pathogenic Biology of the Chinese Academy of Medical Sciences, jointly completed a follow-up study. The study systematically and comprehensively assessed the health status of COVID-19 patients with different disease severities during hospitalization for 6 months after the onset of illness. The study found that more than 70% of patients still have at least one symptom, mainly fatigue or muscle weakness, but almost all patients' daily lives have not been affected; 23% of patients have anxiety or depression, which is more serious and more common in female patients at hospitalization; the positive rate and titer of neutralizing antibodies are significantly lower than in the acute phase; and patients with more severe conditions at the time of hospital have a higher risk of diffuse lung dysfunction and chest abnormalities, which is a key focus after discharge.

<h1 class="pgc-h-arrow-right" data-track="20" > definitive pathogenesis is critical to improving patient outcomes </h1>

The COVID-19 pandemic continues, and there are still many issues to be addressed in the long-term prognosis of COVID-19 patients. For example, at present, follow-up studies are highly heterogeneous, and there is an urgent need to clarify the internationally recognized case definition, establish a core outcome set and develop a common case reporting table, standardize the details of follow-up studies, facilitate follow-up studies, and integrate and compare data. Currently, follow-up studies are still relatively short in duration and require dynamic longitudinal long-term follow-up to assess the natural history of the disease during the recovery phase and to describe the entire disease spectrum. At present, the clinical manifestations of sequelae recorded in the study are diverse, heterogeneous, and the underlying mechanism is not clear, and a clear pathogenesis is crucial to forming preventive and therapeutic measures to improve the prognosis of patients.

This article is derived from the "Daily Newsletter" produced by Physician Daily at the 2021 Annual Meeting of the Respiratory Physician Branch of the Chinese Medical Doctor Association and the 20th China Respiratory Physicians Forum.