Coronavirus: Majority of patients not fully recovered after five months

Researchers found that each patient had an average of nine persistent symptomsand the most commonly reported included muscle pain, fatigue, impaired sleep quality, joint pain or swelling, limb weakness, breathlessness and memory problems.

A fifth of those those who took part in the UK-wide research had reached the threshold for a new disability.

Those who experienced more persistent symptoms tended to be middle-aged, white, female, with at least two ‘co-morbidities’, such as diabetes, lung or heart disease.

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Other research published today involved the University of Glasgow found that women under the age of 50 years-old were five times less likely to report feeling fully recovered, even those who had no underlying health conditions.

More than 300,000 people in the UK have been discharged from hospital following treatment for Covid-19 over the course of the pandemic, including 20,000 from Scotland.

While the study involving 1077 participants only represents a small sample of these patients, it is the largest to report in detail the medium-term health impacts on survivors, who had an average age of 58.

It was led by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre and analysed 1077 patients who were discharged from hospital between March and November 2020 in areas including Glasgow, Lanarkshire and the Highlands.

Of the 67.5 per cent of participants who were working before Covid, 17.8 per cent were no longer employed and nearly 20 per cent experienced a health-related change in their occupational status.

A quarter of participants had clinically significant symptoms of anxiety and depression and 12 per cent had symptoms of post-traumatic stress disorder (PTSD) at their 5-month follow-up.

Professor Chris Brightling, a professor of respiratory medicine at the University of Leicester and the chief investigator for the PHOSP-COVID study, said: “While the profile of patients being admitted to hospital with Covid-19 is disproportionately male and from an ethnic minority background, our study finds that those who have the most severe prolonged symptoms tend to be white women aged approximately 40 to 60 who have at least two long term health conditions, such as asthma or diabetes.” 

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One cluster group in particular showed impaired cognitive function, or what has colloquially been called ‘brain fog’. Patients in this group tended to be older and male.

Cognitive impairment was striking even when taking education levels into account, suggesting a different underlying mechanism compared to other symptoms.

Dr Rachael Evans, an associate professor at the University of Leicester and respiratory consultant at Leicester’s Hospitals, said: “Our results show a large burden of symptoms, mental and physical health problems and evidence of organ damage five months after discharge with Covid-19.

"It is also clear that those who required mechanical ventilation and were admitted to intensive care take longer to recover.

"However, much of the wide variety of persistent problems was not explained by the severity of the acute illness - the latter largely driven by acute lung injury - indicating other, possibly more systemic, underlying mechanisms.”

The research, which has not yet been peer reviewed, also uncovered a potential biological factor behind some post-Covid symptoms and it is hoped this could help inform more personalised treatments.

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Researchers found that in all but the mildest cases of persistent symptoms, levels of a chemical called C-reactive protein [CRP], which is associated with inflammation, were elevated. 

Professor Louise Wain, GSK/British Lung Foundation Chair in Respiratory Research at the University of Leicester, explained: "From previous studies, it is known that systemic inflammation is associated with poor recovery from illnesses across the disease spectrum.

"We also know that autoimmunity, where the body has an immune response to its own healthy cells and organs, is more common in middle-aged women.

"This may explain why post-COVID syndrome seems to be more prevalent in this group, but further investigation is needed to fully understand the processes."

Early indicators from the study also showed that while giving corticosteroids is a factor in reducing mortality in hospital, it does not appear to have an impact on longer term recovery.

Dr Nazir Lone, author on the study and Senior Clinical Lecturer in Critical Care at the University of Edinburgh, said:“ Given that more than 20,000 people have been admitted with COVID-19 to hospitals in Scotland, this study highlights the need for comprehensive care for hospital survivors of Covid-19.”