Long-term follow-up of recovered patients with Covid-19

Long-term follow-up of recovered patients with Covid-19

As Covid-19 infection has now affected more than 83 million people worldwide (and caused 1.8 million deaths) the clinical aftermath is increasingly a concern. The clinical features are varied and include fever, tiredness, muscle pains, lung/respiratory (pulmonary) features from mild upper respiratory tract illness to severe life-threatening viral pneumonia and extra-pulmonary outcomes. 

What is noticeable are the ongoing symptoms including unexpected and significant organ dysfunction after the SARS-CoV-2 infection.
A study in The Lancet on January 08, 2021 reviewed this relevant and important issue.
The study, “6-month consequences of COVID-19 in patients discharged from hospital: a cohort study” was conducted by Chaolin Huang and colleagues describes a clinical follow-up, after 6 months, of a group of 1733 adult patients (48% women, 52% men; median age 57·0 years) with Covid-19 infection who were discharged from a particular hospital in Wuhan, China. 

The findings are listed briefly below:
76% reported at least one symptom that persisted. 
63% reported ongoing fatigue or muscle weakness (these were the commonest symptoms).
26% sleeping difficulties. 
23% anxiety or depression. 
50% still had residual chest imaging abnormalities. 
56% of those who required non invasive and invasive mechanical ventilation during their hospital stay presented with impaired pulmonary function. 
13% unexpectedly who did not did not develop any acute kidney problems during their hospital admission later on displayed abnormal kidney function on blood testing, though this finding ought to be taken with caution. 
4% of this group were those required admission into the Intensive Care Unit. 

The authors of the study conclude that the results support the need for those with severe disease to be given post-discharge care and that further longer term studies ought to be undertaken to fully appreciate the longer term and full spectrum of health consequences from COVID-19. 

The full study is available with this link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext

By Dr Ahmed Bachelani

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