The latest study on the sequelae of novel coronavirus: nearly half of the patients still can’t recover one year after discharge

With the continuation of novel coronavirus pneumonia, symptoms such as persistent fatigue, dyspnea and depression may affect millions of people, but little is known about this.

The global epidemic is still spreading strongly.

At present, the cumulative number of patients with novel coronaviruss has exceeded 220 million, and the cumulative number of cured patients is nearly 200 million.

These figures are still rising.

Recently, the Lancet published a study of the sequelae of novel coronavirus patients (also known as the “long term novel coronavirus”), which woke up the alarm of COVID-19’s long-term impact on mankind.

Novel coronavirus pneumonia is a very popular medical journal.

This authoritative medical journal has issued an editorial that it is very rare to know that the symptoms of persistent fatigue, dyspnea and depression may affect millions of people as the novel coronavirus pneumonia continues.

What are the long-term effects of COVID-19 infection? What are the characteristics, severity and duration of these symptoms? There has been no clear answer to these questions, and this study gives the latest data on the sequelae of the novel coronavirus.

Still unable to fully recover after 1 year The study published in the lancet on August 28 tracked 1276 Xinguan patients discharged from Wuhan Jinyintan hospital, and studied their rehabilitation by following up their health status and quality of life 6 and 12 months after discharge.

The study was led by Cao Bin of the Department of respiratory and critical care medicine of China Japan Friendship Hospital, Wang Xianguang of Wuhan Jinyintan hospital, and Wang Jianwei of the national respiratory medicine center and the Chinese Academy of Medical Sciences.

Cao Bin’s team published the follow-up of the same group of patients six months after discharge in the lancet in January this year.

At that time, they found that about three-quarters of the novel coronavirus survivors still had at least one continuous symptom such as “fatigue or muscle weakness” after discharge.

Patients with critical illness during hospitalization are more likely to have pulmonary gas diffusion disorder and imaging abnormalities than patients with lower disease severity.

In this study, the research group counted all patients discharged from Jinyintan hospital from January 7 to May 29, 2020, a total of 2469.

Among them, 1193 patients were excluded from the study for many reasons, including death after discharge, living in a nursing home or welfare home, dementia or mental illness, osteoarthropathy, etc.

Finally, 1276 patients were included in the study and completed two follow-up visits 6 months and 12 months after discharge.

The median age of these patients was 59 years old.

864 patients inhaled oxygen through nasal catheter and mask during hospitalization.

94 patients needed transnasal high flow oxygen therapy or noninvasive ventilation and invasive mechanical ventilation.

54 patients had been admitted to ICU.

It can be seen that most patients belong to severe and dangerous cases.

During hospitalization, these patients received corticosteroids, antiviral drugs, lopinavir, abidol, chloroquine phosphate, hydroxychloroquine, antibiotics, intravenous immunoglobulin, etc.

During the two follow-up visits, the patients received detailed face-to-face interview, physical examination and 6-minute walking test.

They also completed a series of questionnaires to reflect their respiratory status, quality of life, medical treatment after discharge, work status, etc.

According to the severity of the patients, the researchers randomly sampled their lung function and chest CT at 6 months after discharge, and further rechecked some people as needed at 12 months after discharge.

In addition, the researchers recruited community adults who had not been infected with Xinguan from Wuhan as the control group.

The novel coronavirus survivors and the control group were further matched 1:1 according to age, gender and basic diseases.

Because of the long span and large sample size, this study is considered to be the largest study of novel coronavirus survivors so far.

The results showed that most patients with novel coronavirus recovered well with the passage of time after discharge, and had recovered their original work and life, but their current health status was still lower than that of the control population.

Sleep disorders, hair loss, taste and smell disorders, headache, joint pain, anxiety or depression…

These symptoms were included in the sequelae of the novel coronavirus.

Compared with 6 months after discharge, some sequelae subsided significantly over time at 1 year after discharge.

The proportion of people with at least one sequelae also decreased from 68% at 6 months to 49% at 12 months.

Similar to SARS’s sequelae, fatigue or muscle weakness is the most common symptom in new coronal patients.

The proportion of patients with this symptom has dropped from 52% in 6 months to 20% in 12 months.

However, the cause and pathogenesis of fatigue and muscle weakness after infection with novel coronaviruss are unclear.

Based on previous studies of SARS, the ability of lung diffusion, the inflammation of muscle caused by virus, cytokines, muscle atrophy and degeneration, corticosteroid myopathy or the combination of these factors may be triggers.

In contrast to the decline of the above symptoms, the proportion of dyspnea, anxiety and depression in Xinguan patients 12 months after discharge was higher than that six months ago.

The proportion of dyspnea increased slightly from 26% at half a year to 30% at 12 months.

Over a period of up to 12 months, about 20% – 30% of moderate patients observed pulmonary diffusion disorder, which was as high as 54% in critically ill patients.

In addition, more patients had anxiety or depression 12 months after discharge (26%), compared with 23% 6 months after discharge.

“Maybe these people themselves have some chronic diseases.

Therefore, it is not clear that these symptoms of dyspnea are caused by lung injury during infection with the novel coronavirus,” Jin Dongyan, a professor and virologist at the school of biomedicine of the University of Hong Kong, told China Newsweek.

The article analyzed that the chronic or delayed psychological symptoms after infection with novel coronavirus may be the direct impact of virus infection, or it may be due to abnormal immune response, over activation of immune system or autoimmune response.

In addition, reduced social contact, loneliness, incomplete physical recovery and unemployment may also affect the mental symptoms of patients.

In Jin Dongyan’s view, although based on large-scale sample statistics, the definition of sequelae of novel coronavirus is somewhat broad.

He said, after all, social discrimination, patients themselves too worried about the body may cause depression and insomnia symptoms, rather than the direct symptoms caused by COVID-19 infection.

In his view, the sequelae of these 1276 patients were caused by COVID-19, which were caused by therapeutic drugs, which were caused by psychological and mental problems.

These problems still need further exploration.

(source: observer network)..