70% of Covid hospital patients not fully recovered five months after discharge

Seven in 10 patients admitted to hospital with Covid-19 had not fully recovered five months after being discharged, a study suggests.

These people continued to experience negative impacts on their physical and mental health, as well as ability to work, according to results released by the PHOSP-Covid study.

The UK-wide study analysed 1,077 patients discharged from hospital between March and November 2020 following an episode of coronavirus.

According to the findings, each participant had an average of nine persistent symptoms.

The 10 most common were muscle pain, fatigue, physical slowing down, impaired sleep quality, joint pain or swelling, limb weakness, breathlessness, pain, short-term memory loss, and slowed thinking.

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, the research suggests.

It also indicated that one in five of the participant population reached the threshold for a new disability.

The UK-wide study, led by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre – a partnership between Leicester’s hospitals, the University of Leicester and Loughborough University – and jointly funded by the NIHR and UK Research and Innovation,

The study also reported that more 25% of participants had clinically significant symptoms of anxiety and depression, and 12% had symptoms of post-traumatic stress disorder (PTSD) at their five-month follow-up.

Researchers found that of the 67.5% of participants who were working before they had the disease, 17.8% were no longer working, and nearly 20% experienced a health-related change in their occupational status.

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.”

Researchers classified types of recovery into four groups, based on the mental and physical health impairments of participants.

One cluster in particular – which tended to be older and male – showed what has come to be known as brain fog – impaired cognitive function.

Rachael Evans, an associate professor at the University of Leicester and respiratory consultant at Leicester’s hospitals, said patients who require mechanical ventilation and are admitted to intensive care take longer to recover.

She added: “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 study also found that a biological marker associated with inflammation – C-Reactive Protein (CRP) – is elevated in all but the most mild of post-hospital cases

Professor Louise Wain, GSK/British Lung Foundation chairwoman in respiratory research at the University of Leicester and co-investigator for the PHOSP-Covid study, said: “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.”

The researchers said more than 300,000 survivors in the UK have been discharged from hospital following Covid-19, but the study only represents a small sample of these.

They note that participants in this study are younger than the whole population in the UK that survived hospital admissions for coronavirus.

Professor Chris Whitty, England’s chief medical officer and co-lead for the NIHR, said: “We are in the foothills of our understanding of long-term effects of Covid.

“It is important that we work out what exactly the various elements of what is currently termed long Covid are so we can target actions to prevent and treat people suffering with long-term effects.”

Health Secretary Matt Hancock said: “I know long Covid can have a lasting and debilitating impact on the lives of those affected and I’m determined to improve the care we can provide.”

The study was published as a pre-print on medRxiv and has not yet been peer-reviewed.