Nearly one-third of patients who suffered only mild Covid-19 still had symptoms like shortness of breath, fatigue and joint pain a year after infection, a study in Wuhan has found.
Although the study was small, involving just 120 patients, it offers a rare glimpse into the long-term health of survivors of Covid-19 in China, especially those who were not severely ill.
China, where Covid-19 was first identified, has yet to publish any large-scale data on patients suffering lingering symptoms.
A study published in The Lancet medical journal in August of about 1,200 patients at the Wuhan Jinyintan Hospital – which admitted mostly severely ill patients during the outbreak – found nearly half still had symptoms a year after they first became ill.
A paper published in Chinese peer-reviewed journal Frontiers in Medicine on Tuesday (Nov 23) reported findings from 120 patients admitted to the Wuhan Union Hospital west district and Fangcang shelter hospitals between Jan 29 and April 1 last year.
They had their post-infection health status evaluated after about 314.5 days, according to researchers from the Union Hospital, Tongji Medical College, and Huazhong University of Science and Technology in Wuhan, who published the findings.
The study found sleep difficulties, shortness of breath, fatigue and joint pain were commonly observed during follow-up and nearly one-third of “non-severe” patients – 86.7 per cent of the total – had these symptoms.
More than 56 per cent of the patients who originally had symptoms that were not severe still showed abnormal findings in their CT scan nearly one year after infection, including ground-glass opacities, bronchiectasis, nodules and fibrosis.
But compared to the residual lung lesion volume in a previous study six months after the onset of the symptoms, it showed significantly less volume of bilateral pulmonary lesions.
It suggested that, although some patients showed abnormalities in the radiographic images, the intensity of damage was small and the lesions were still healing.
The researchers believed abnormal liver function results detected in the study did not necessarily mean the damage persisted after acute injury but it was likely caused by factors such as drugs or over-nutrition.
They called for long-term follow-up studies because the liver and kidney function test results of participants before Covid-19 were not available.
Nearly 40 per cent of those patients showed higher than normal scores on the Hamilton anxiety rating scale and over 37 per cent on the Hamilton depression rating scale.
Some study participants suffered from impaired health-related quality of life, which may be associated with a combination of factors, including injured lungs caused by the viral infection, the long period of isolation, and anxiety caused by the pandemic.
“At the nearly one-year follow-up, Covid-19 survivors still had multi-system issues, including those in respiratory function … quality of life, and anxiety and depression … Conducting follow-ups and preventing the reinfection of Sars-CoV-2 [the coronavirus that causes Covid-19] in this group is necessary,” researchers wrote.
They noted it was a small study and said baseline data from before the patients were infected and during the acute infection were not available, so the abnormal health status of Covid-19 survivors could not be attributed exclusively to the viral infection.
Long Covid is officially recognised by the World Health Organisation (WHO) as a post-Covid-19 condition.
Lingering symptoms in recovered patients – usually three months from the onset of symptoms and lasting at least two months – which cannot be explained by an alternative diagnosis have become a global public health concern.
In May, China published a guideline on rehabilitation to help heal patients who are free of the virus but still suffer lingering symptoms in their heart and lungs, body movement and mental health.
This article was first published in South China Morning Post.