The first batch of China's COVID-19 patients still cannot fully recover

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The first batch of China’s COVID-19 patients still cannot fully recover

One year after being discharged from the hospital, how are the patients with Wuhan Covid-19?

Even if they are not severely ill, discharged patients still experience multiple system problems nearly a year after being diagnosed with COVID-19 pneumonia

On November 23, a research paper published in ” Frontiers in Medicine ” received widespread media attention.

The article shows that among the patients discharged from hospital with COVID-19 pneumonia participating in the study, 1/3 of the non-critical patients still have the above abnormal symptoms about 1 year after the onset. 56.7% of patients had impaired lung function, and CT showed abnormalities.

The article is titled Assessment of Sequelae of COVID-19 Nearly 1 Year After Diagnosis , completed by researchers from Union Hospital (Wuhan Union Hospital) , Tongji Medical College, Huazhong University of Science and Technology . It aims to assess the sequelae of patients with COVID-19 pneumonia nearly 1 year after the diagnosis. , Focusing on the rehabilitation of non-critically ill patients.

The first batch of China’s COVID-19 patients still cannot fully recover

The study included 120 patients with COVID-19 pneumonia who were discharged from Wuhan Union Hospital and Fangcai Hospital from January 29 to April 1, 2020. The average age of the patients was 51.6±10.8 years, of which 104 were non-severe cases (86.7%) and 16 cases were severe (13.3%) .

Studies have shown that in the past 1 year of follow-up, the most common sequelae of discharged patients were difficulty sleeping (52 cases, 43.3%) , shortness of breath (49 cases, 40.8%) , fatigue (43 cases, 35.8%) and joint pain (39 cases, 32.5%) .

In terms of liver and kidney function, only a few discharged patients had abnormal transaminase and creatinine indicators. However, due to the lack of examination results before infection, the abnormal liver and kidney function cannot be completely attributed to the COVID-19 pneumonia, and long-term follow-up studies are required.

Regarding lung function, the study conducted chest CT examinations on 97 discharged patients, of which up to 55 (56.7%) discharged patients showed abnormal CT, including 47 non-critical patients and 8 severely ill patients with impaired lung function. The most common imaging abnormalities were nodules, linear shadows, and fibrosis, which accounted for 55.7%, 47.4%, and 17.5%, respectively.

In the proportion of dyspnea patients with mMRC score ≥1, critically ill patients were significantly higher than non-critically ill patients. Of the 16 critically ill patients, 12 had a score of ≥1, accounting for 75%. The same data is 46 cases (38.3%) of non-critical patients .

In addition, 30 discharged patients developed pulmonary diffusion impairment (diffusion impairment) . This refers to obstacles in the physical diffusion process of O 2 , CO 2 and other gases exchanged through the alveolar membrane. This proportion is 37.5% in critically ill patients.

However, the paper pointed out that compared with the study 6 months after the onset of symptoms, the volume of bilateral lung lesions in the discharged patients in this study was significantly smaller, suggesting that the lesions may continue to fade.

Regarding the occurrence of persistent pulmonary diffusion disorder and imaging abnormalities, another Chinese scholar previously published a paper in The Lancet, stating that strategies to prevent or improve sequelae should be explored in patients discharged from the hospital with severe COVID-19 pneumonia. There are very few severely damaged patients, but for most patients, it is impossible to fully recover after one year. It will take longer for them to recover to their pre-onset health.”

The threat of “long COVID-19”

The psychological state of patients discharged from hospital with COVID-19 pneumonia is also of concern.

Through the Hamilton Anxiety Scale and Depression Scale, the researchers found that 50 (41.7%) patients had anxiety symptoms, of which 21 were more serious. Forty-five (37.5%) patients developed depressive symptoms, and 6 patients were more serious.

The first batch of China's COVID-19 patients still cannot fully recover

However, there is no significant difference in the ratio of anxiety to depression between severe and non-severe COVID-19 pneumonia discharged patients.

According to previous papers published by Chinese scholars in The Lancet, the self-assessment scores of the quality of life of COVID-19 patients are also low. After 1 year, during the follow-up, 11% of the survivors were affected in their daily activities, 29% experienced pain and other discomforts, and 26% had anxiety or depression. The corresponding proportions were only 6%, 5%, and 5% in the uninfected group.

The research team of Wuhan Union Medical College Hospital stated in this paper that discharged patients have encountered multiple system problems in the past year after being diagnosed with COVID-19 pneumonia, even in non-severe cases. This suggests that doctors should pay attention to the care of non-critically ill patients after they are discharged from the hospital and conduct adequate research to understand the health consequences of viral infections and prevent secondary infections.

It is worth noting that as early as August this year, “The Lancet” published an editorial, claiming that ” long covid ” (long covid) is the primary challenge of modern medicine.

According to the latest clinical definition of “Changxin Corona” published by the World Health Organization, it refers to abnormal symptoms that appear within 3 months after infection, last for at least 2 months, and cannot be clearly explained, including fatigue, shortness of breath, and cognitive dysfunction. . In addition, patients may also have chest pain, loss of smell and taste, muscle weakness, and heart palpitations, and even have long-term effects on multiple body parts such as the lungs, cardiovascular and nervous systems, and mental health.

The editorial stated that as the COVID-19 pneumonia pandemic continues, symptoms such as persistent fatigue, dyspnea and depression may affect millions of people, but little is known about this situation. Because there is no proven treatment method and rehabilitation guidance, the “long-term COVID-19” will affect people’s ability to return to normal life and work, and at the same time increase the burden of medical care and aggravate economic losses.

WHO Director-General Tedros Adhanom Ghebreyesus called on countries to give priority to the development of awareness, rehabilitation and research on the “long-term COVID-19”, and to collect data for the “long-term COVID-19”. At the same time, the scientific and medical communities must cooperate to explore the mechanism and pathogenesis of the “long-term COVID-19”, estimate the global and regional disease burden, understand how vaccines affect the disease, and find effective treatments through randomized controlled trials.

At the same time, health care providers must recognize and verify the impact of the “long-term COVID-19” on patients, and the health system needs to set personalized, patient-oriented goals.

Reference: the medical community

(source:internet, reference only)

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