Effective Interventions Urgently Required For Long #Covid

One year after having COVID-19, only around one in four patients feel fully well again.

That’s the results of a survey of more than 2,000 patients in the UK . The study was led by Professor Christopher Brightling, Dr Rachael Evans, and Professor Louise Wain, National Institute for Health Research Leicester Biomedical Research Centre, University of Leicester, UK and colleagues. Their report was published  in The Lancet Respiratory Medicine.

A total of 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (33%) participants completed both the 5-month and 1-year visits at the time of analysis (and the study is ongoing). 

Of the 807 patients:

  • the mean age was 59 years
  • 279 (36%) were women
  • 28% received invasive mechanical ventilation.

The proportion of patients reporting full recovery was similar between 5 months (501 [26%] of 1965) and 1 year (232 [29%] of 804).

Dr Evans explained:

“The limited recovery from 5 months to 1 year after hospitalisation in our study across symptoms, mental health, exercise capacity, organ impairment, and quality-of-life is striking.

“We found female sex and obesity were major risk factors for not recovering at 1 year… In our clusters, female sex and obesity were also associated with more severe ongoing health impairments including reduced exercise performance and health-related quality of life at 1 year, potentially highlighting a group that might need higher intensity interventions such as supervised rehabilitation.”

The people surveyed lived throughout the UK. The long term effects of contracting Covid-19 – ‘long Covid’ – are having a serious impact on the health and wellbeing of hundreds of thousands of people.

Professor Wain said:

“No specific therapeutics exist for long COVID and our data highlight that effective interventions are urgently required.

“Our findings of persistent systemic inflammation, particularly in those in the very severe and moderate with cognitive impairment clusters, suggest that these groups might respond to anti-inflammatory strategies. The concordance of the severity of physical and mental health impairment in long COVID highlights the need not only for close integration between physical and mental health care for patients with long COVID, including assessment and interventions, but also for knowledge transfer between health-care professionals to improve patient care.

“The finding also suggests the need for complex interventions that target both physical and mental health impairments to alleviate symptoms. However, specific therapeutic approaches to manage post-traumatic stress disorder might also be needed.”

Professor Brightling added:

“Our study highlights an urgent need for health-care services to support this large and rapidly increasing patient population in whom a substantial burden of symptoms exist, including reduced exercise capacity and substantially decreased health-related quality of life 1 year after hospital discharge.

“Without effective treatments, long COVID could become a highly prevalent new long-term condition. Our study also provides a rationale for investigating treatments for long COVID with a precision-medicine approach to target treatments to the individual patient’s profile to restore their health-related quality of life.”

 Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: prospective observational study – was presented at a special Lancet journals COVID-19 session in Hall A of the European Congress on Clinical Microbiology & Infectious Diseases (ECCMID 2022) on Sunday April 24 at 16.15-18.15 Lisbon/UK time (WEST time zone).

As of April, 2022, more than 500 million cases of SARS-CoV-2 infection have been reported worldwide, with 21·7 million cases in the UK and over 820 000 patients in the UK admitted to hospital for COVID-19. This population is at high risk of persisting health impairments 6 months after discharge associated with reduced physical function and health-related quality of life. It is essential to understand both the longer-term trajectory of recovery to identify ongoing health-care needs and the required response by health-care systems and policy makers for this already large and ever-increasing population.

Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study

4 replies »

  1. I recently wrote this as a comment to an item in The Orkney News and think it’s worth repeating here.…..

    “Beginning about 9 years ago, I was very ill. Part of that illness included contracting a particularly unpleasant virus. It took me at least three months to clear the virus and also start to recover from the other aspects of the illness.
    I now have what the nurse described as Post Viral Fatigue Syndrome. I could say that illness wrecked my life – but I won’t, as I didn’t let it. But – it changed it, dramatically. There is much that I can’t do. Sheer cussedness gets me through a lot. One of the doctors said that the recovery I had was partly due to my attitude.
    I am older now, and would probably be heading for retirement anyway, but the idea of my working after that illness, is a joke. ‘Tiredness’ doesn’t cover how a person feels with this condition. Brain fog? The word processor is a gift, as I can write something in pieces when I have some energy, then go over it again and again to correct the gobbledegook that comes through my fingers at first. It takes at least 3 goes to clear up the weird spellings and general – mess. Brain fog – no, that doesn’t cover it either.
    Folk don’t understand how I appear to be able to write clearly, but lose words and get confused when trying to talk with people.
    I avoid telephone conversations because I get tired and lose track of what’s going on.
    Anyway – I’m writing this to say – remember that COVID IS A VIRUS – and as far as I can see, Long Covid is a Post Viral condition, sharing many symptoms with Post Viral Fatigue Syndrome. If a large number of the population are left with Long Covid and are in something like the state I’m in – well – that don’t help the economy either – does it?
    I have a good life in many ways – and am fortunate to be in the situation I am in. Others are not so fortunate, in various ways. I feel bad that my way of being limits my husband’s life – he says it’s OK – he’s just pleased that I’m here at all. Bless him.
    The key, basic thing to do is – AVOID GETTING COVID – if you possibly can! Follow the guidelines listed above – and/or JUST USE SOME SENSE!”

    • I keep thinking it is like shingles – which I’ve had. Yes, avoid getting covoid. Once you’ve had it, avoid getting tired – take a step back, rather than do just one more thing and then rest – too late! Step back to move forward

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