Huang and others published this study in The Lancet August 28th 2021.

The full range of long term health consequences of COVID-19 in patients who are discharged from hospital is largely unclear.  

The aim of this study was to comprehensively compare consequences between 6 months and 12 months after symptom onset amongst hospital survivors with COVID-19.  

They undertook an ambidirectional cohort study of COVID-19 survivors who had been discharged from Jin Yin-tan Hospital Wuhan between January 7th and May 29th 2020.

At 6 month and 12 month follow-up visits survivors were interviewed with questionnaires on symptoms and health-related quality of life and also received a physical examination, a 6 minute walking test, and laboratory tests.  

They were required to report their healthcare use after discharge and work status at the 12 month visit.  Survivors who had completed pulmonary function tests or had lung radiographic abnormality at 6 months were given the corresponding tests at 12 months.  

Non-COVID-19 participants controlled were matched for age, sex and comorbidities were interviewed and completed questionnaires to assess prevalent symptoms.  The primary outcomes were symptoms, modified British Medical Research Council scores etc. and distance walked in 6 minutes.  Multivariable adjusted logistic regression models were used to evaluate the risk factors following 12 month outcomes.

1276 COVID-19 survivors completed both visits.  The median age of patients was:

  • 59 years and 681 were men 53%. 
  • The median follow-up time was 185·days for the 6 month visit 
  • 349 days for the 12 month visit after symptom onset. 

The proportion of patients with at least one sequelae symptom decreased from 68% at 6 months to 49% at 12 months.  The proportion of patients with dyspnoea, characterised by an mMRC score of 1 or more, slightly increased from 26% at the 

6 month visit to 30% at the 12 month visit.  Additionally, more patients had anxiety or depression at the 12 month visit versus at the 6 month visit, 26% versus 23%.

There was no significant difference on 6 minute walking distance observed between 6 months and 12 months.  88% of patients who were employed before COVID-19 had returned to their original work at 12 months.  Compared with men, women had an odds ratio of 1.43 for fatigue or muscle weakness, 2 for anxiety or depression and 2.97 for diffusion impairment.  Matched COVID-19 survivors at 12 months had more problems with mobility, pain or discomfort and anxiety or depression and had more prevalent symptoms than did controls.  

The study interpretations were that most COVID-19 survivors had a good physical and functional recovery during the one year follow-up and had returned to their original work and life.  However, the health status in the cohort of COVID-19 survivors at 12 months was still lower than that in the control population.

LGP, the London General Practice, the leading London doctor’s clinic in Harley Street offers a full COVID support service.  If you feel that you have symptoms of long COVID, we offer a full multidisciplinary team to enable you to recover as fully as possible.

Dr Paul Ettlinger

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