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[ICU Management & Practice]: 新冠肺炎发病后6个月的随访结果
2021年03月04日 研究点评, 进展交流 暂无评论

COVID-19 Consequences Six Months After Symptom Onset

Findings from a follow-up study conducted with 1733 patients first diagnosed in Wuhan, China, show that nearly 76% of these patients had at least one symptom six months after symptom onset. Findings are published in The Lancet.

The study included patients discharged from Jin Yin-tan Hospital in Wuhan, China, who were diagnosed with COVID-19 between January and May and who were followed to June and September. The study looked at the long-term effects of COVID-19 on patients hospitalised in Wuhan. Patients were interviewed face-to-face using questionnaires. They also underwent lab tests, physical examinations, and a walking test. Also, 390 patients underwent additional testing, including assessment of lung function, while 94 patients whose antibody levels were recorded at the peak of infection received a follow-up test. 

Nearly three-quarters of the patients had a minimum of one ongoing symptom six-month from symptom onset. The most common ongoing symptom was fatigue or muscle weakness (63%). Sleep difficulties (26%) and anxiety or depression (23%) were also frequently reported. 

Severely ill patients had impaired lung function and abnormalities, which could indicate organ damage six months after symptom onset. Findings also show that the levels of neutralising antibodies fell by more than half after six months in 94 patients. This raises concerns about the possibility of reinfection by the virus.

Nearly three-quarters of COVID-19 patients had a minimum of one ongoing symptom six-months from symptom onset.

390 patients underwent additional testing, out of which 349 completed the lung function test while 41 could not do so due to poor compliance. Patients with severe illness had reduced lung function. 56% of the patients who were at a severity scale of 5-6 and who required ventilation experienced diffusion impairment. 29% of patients with severe COVID-19 disease (severity scale 5-6) also performed worse in the six-minute walking test compared with 24% of those on a severity scale of 3 and 22% of those on a severity scale of 4.

To date, very little is known about the long-term consequences of COVID-19, as very few follow-up studies have been conducted. However, findings from this study indicate that a large majority of patients infected with COVID-19 continue to live with at least some effects of the virus even after they have been discharged from the hospital. This suggests a need for post-discharge care for those with severe COVID-19 infections. 

Previous research on patient outcomes after ICU stay also suggests that critically ill COVID-19 patients have to deal with cognitive and mental health impairment as well as issues with physical function far beyond hospital discharge. This study also confirms these findings. However, there is still a need for longer follow-up studies in a larger population to fully understand the full spectrum of consequences in COVID-19 patients. 

Source: The Lancet

References:

Huang C,  Huang L,  Wang Y et al. (2021) 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet. 10.1016/S0140-6736(20)32656-8. 

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