Study: Half of hospitalized coronavirus patients have symptoms 4 months after discharge

By Christopher Cheney

Many coronavirus patients hospitalized with severe acute respiratory infection experience significant respiratory, functional, and psychological symptoms four months after hospital discharge, a recent research article found.

Gary Rogg, MD, an attending physician in internal medicine and co-director of the Post-COVID-19 Recovery Program at Westchester Medical Center in Valhalla, New York, says coronavirus “long haulers” can have a range of long-term symptoms. Those symptoms include cough, shortness of breath, anxiety and depression, cardiac issues, constitutional symptoms such as numbness and tingling, deconditioning, and hair loss.

The recent research article, which was published by JAMA Network Open, features data collected from 219 patients at an academic hospital in Northern Italy. The researchers measured lung impairment, functional impairment, and posttraumatic stress symptoms.

Measurement of lung function impairment was based on diffusing lung capacity for carbon monoxide (DLCO). Lung function impairment was considered present if the DLCO level was less than 80% of expected value. Severe lung function impairment was considered present if the DLCO level was less than 60% of expected value.

Functional impairment was assessed using the Short Physical Performance Battery score and a two-minute walking test. Posttraumatic stress symptoms were assessed using the Impact of Event Scale–Revised total score.

The study generated several key data points:

  • DLCO was less than 80% of the expected value in 51.6% of patients
  • DLCO was less than 60% of the expected value in 15.5% of patients
  • Functional impairment was found in 53.8% of patients
  • Posttraumatic stress symptoms were found in 17.2% of patients

“We found that a significant proportion of survivors of COVID-19 experienced respiratory or functional impairment four months after hospital discharge, with clinically relevant psychological consequences,” the study’s co-authors wrote.

Among hospitalized patients with severe acute respiratory infection, coronavirus long haulers are relatively common, the lead author of the study told HealthLeaders.

“In our study, we confirmed that a relevant proportion of patients still complains of COVID-19 symptoms months after the acute phase of their illness. The most frequent symptoms were fatigue and reduced tolerance to exercise,” said Mattia Bellan, MD, PhD, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy.

The severity and duration of COVID-19 symptoms after hospital discharge poses challenges to many patients and requires further research, Bellan said. “These symptoms have an impact on the quality of life of these patients since they often have the perception of being generally unwell. Whether these sequelae will persist over time is a major public health issue that needs to be assessed in the future.”

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.

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COVID-19, Infection Control