(CNN) — Even two years after their initial infection, most people who were hospitalized for COVID-19 early in the pandemic had persistent symptoms, according to a new study that may be one of the longest and largest on record. to follow people with prolonged covid.
The study, published Wednesday in The Lancet, found that 55% of patients still had at least one symptom of Covid-19 two years later. That was actually an improvement from six months after infection, when 68% had symptoms.
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Researchers from the China-Japan Friendship Hospital analyzed the records of 1,192 people who had been hospitalized at Jin Yin-tan Hospital in Wuhan, China, and were discharged between January 7 and May 29, 2020.
The researchers reviewed six months, 12 months and two years after the patients were discharged and asked them about their subjective assessment of symptoms. The participants were also evaluated using more objective medical tests, including lung function tests, CT scans and six-minute walk tests.
Overall, the participants were in worse health two years later. Those who had prolonged COVID-19 symptoms listed pain, fatigue, trouble sleeping, and problems with their mental health. Patients who received high-level respiratory support while hospitalized had more long-term lung problems than others.
Participants with prolonged symptoms also went to the doctor more often than before the pandemic. They found it more difficult to exercise and generally reported a poorer quality of life. Most had returned to work, but it is not clear if they were working at the same level as before they got sick.
Study co-author Dr. Bin Cao, of the China-Japan Friendship Hospital, hopes the research will encourage doctors to ask follow-up questions of their patients who had Covid-19, even years after initial infection.
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“There is a clear need to provide ongoing support to a significant proportion of people who have had COVID-19 and to understand how vaccines, emerging treatments and variants affect long-term health outcomes,” Cao said in a news release. .
The study has some limitations. The researchers did not compare the results with people who were hospitalized for reasons other than COVID to see if they also had persistent symptoms. They compared the hospitalized group with people in the community who never had covid-19; that group also had health problems a year later, but that happened in about half as many people as in the hospitalized group.
Another limitation was that the research involved a single hospital, so the results may not be universal for all hospitalized COVID-19 patients. At the beginning of the pandemic, patients were generally staying in hospital longer than they are now, and that could have an effect on the duration of symptoms. And because the research was done early in the pandemic, it’s not clear if there would be similar results in people who got sick with later variants of the coronavirus or those who had been vaccinated.
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Dr. Devang Sanghavi, a critical care specialist who does long-term covid research and works with patients who have it at the Mayo Clinic in Jacksonville, Fla., hopes future studies on this condition will include vaccination status.
“The only thing I know I can safely offer patients with prolonged Covid is vaccination,” said Sanghavi, who was not involved in the study. “When we compare unvaccinated patients with vaccinated patients and look at the incidence of long-Covid symptoms, vaccinated patients have less severe symptoms and less often have long-Covid.”
Like the authors, Sanghavi hopes the study will help policymakers realize how important it is to fund long-term Covid research and build infrastructure to better accommodate long-term patients. There could be millions of people with prolonged covid, studies suggest.
“Right now, these patients sometimes seem like an afterthought,” Sanghavi said.
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“The study points out how many people are likely to need help. I don’t know if you’ve tried to get an appointment for a primary care visit, but it can take weeks or even months in many places. And that’s just for a simple checkup: forget prolonged covid. That’s a lot longer,” she said.
Sanghavi said more doctors will also need to be trained on how to help people with long Covid. “Our health care system is not prepared for the kind of influx of patients this condition will bring.”
Dr. Kristine Erlandson, an associate professor of medicine and infectious disease specialist at the University of Colorado, has been doing her part by recruiting participants for a study on the long-term impact of covid-19. The initiative is part of the National Institutes of Health RECOVER trial.
Erlandson said so many people want to know more about the long-running covid that his colleagues haven’t even had to announce the trial; there is a waiting list to get in.
The new research aligns with what staff are seeing at those long-distance clinics.
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“This is similar to what we are hearing from patients in the United States, who are still experiencing symptoms at two years, particularly in the first wave of patients in the pandemic. We’ve heard this anecdotally, so it’s always good to see things published,” said Erlandson, who was not involved in the study. Patients in his clinic also have similar symptoms, with sleep difficulties and fatigue being the most common.
He stressed that people don’t have to be hospitalized for COVID-19 for having persistent symptoms, and he hopes future research will capture how long non-hospitalized people experience symptoms.
Erlandson also noted that some of the study participants improved after 12 months, but worsened again after two years.
“I think these long studies are interesting to see that it’s not about progressive improvement. People fluctuate a little bit in their improvements,” he explained.
Erlandson said he will be curious if the participants improved beyond those two years or if Covid-19 will become a chronic condition. Doctors can treat certain symptoms, but there is no specific treatment for long covid.
“Unless they have some kind of treatment, I’m concerned that it will have a long-term impact on disability and function for some patients,” he said.
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