A new British study of more than 2,000 patients hospitalized with COVID-19 was presented at the European Conference on Clinical Microbiology and Infectious Diseases (ECCMID 2022, Lisbon 23-26), and published in Lancet Respiratory Medicine He explains that, one year after contracting COVID-19, only one in four patients feel fully comfortable again. The study was led by Professor Christopher Brightling, Dr Rachel Evans and Professor Louise Wayne, from the National Institute for Health Research, Leicester Center for Biomedical Research, University of Leicester, UK and colleagues.
The authors found that a woman being female versus male (32% less likely), being obese (half likely) and having mechanical ventilation in hospital (58% less likely) were all associated with a lower likelihood of feeling fully recovered at one year. . The most common long-term persistent symptoms of COVID-19 were fatigue, muscle aches, physical slowing, lack of sleep and shortness of breath.
This research used data from the posthospital COVID-19 (PHOSP-COVID) study that evaluated adults (aged 18 years and over) who were hospitalized with COVID-19 across the UK and subsequently discharged. Patients from 39 UK National Health Service (NHS) hospitals*, who agreed to five-month and one-year follow-up assessments in addition to their clinical care, were included. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge. The researchers also took blood samples from the participants in the five-month visit to be analyzed for the presence of various inflammatory proteins.
A total of 2,320 participants who were discharged from hospital were assessed between 7 March 2020 and 18 April 2021, 5 months after hospital discharge, and 807 (33%) of the participants completed visits that lasted 5 months and 1 year at the time of analysis. (The study is in progress). The median age of these 807 patients was 59 years, and 279 (36%) were women and 28% had received invasive mechanical ventilation. The proportion of patients reporting complete recovery was similar between 5 months (501 .). [26%] 1965) and one year (232 [29%] from 804).
In a previous publication of this study* the authors identified four groups or ‘clusters’ of symptom severity at five months, which this new study confirmed in one year. Of the 2,320 participants, 1636 had sufficient data to allocate them to a group: 319 (20%) had a severe physical and mental health disability, 493 (30%) had a severe physical and mental health disability, and 179 (11%) had a severe physical or mental health disability of moderate physical disability. Impaired health with cognitive impairment, and 645 (39%) moderate mental and physical impairment. Obesity, decreased ability to exercise, a greater number of symptoms, and increased levels of C-reactive protein, a biomarker of inflammation, were associated with more severe clusters. In both the severe and moderate cognitive impairment groups, levels of the inflammatory biomarker interleukin-6 (IL-6) were higher when compared to the mild group.
“The limited recovery from 5 months to 1 year after hospitalization in our study in terms of symptoms, mental health, ability to exercise, organ dysfunction, and quality of life is astonishing,” says Dr. Evans.
She adds, “We found that female gender and obesity were major risk factors for not recovering at one year… In our cohorts, female gender and obesity were also associated with more serious persistent health impairments including decreased exercise performance and health-related quality of life at one year, possibly That highlights a group that may need high-intensity interventions such as supervised rehabilitation.”
On the prolonged lack of current treatments for COVID, Professor Wayne says: “There have been no specific treatments for COVID for a long time and our data highlight that effective interventions are urgently needed. Our findings indicate persistent systemic inflammation, particularly in the severe and medium-sized cognitive impairment groups. , suggests that these groups may respond to anti-inflammatory strategies.The concordance between the severity of poor physical and mental health in a prolonged period of coronavirus infection highlights the need not only for the close integration of physical and mental health care for patients with prolonged COVID-19 infection, including assessment and interventions, but also for the transfer of knowledge among health care professionals in order to improve patient care.The results also indicate the need for complex interventions that target physical and mental health disabilities to alleviate symptoms.However, specific treatment approaches may also be needed to manage PTSD Shock “.
Professor Breitling concludes: “Our study highlights the urgent need for healthcare services to support this large and rapidly increasing number of patients with a significant burden of symptoms, including reduced ability to exercise and significantly reduced health-related quality of life after one year. Discharge. Without effective treatments, long-term COVID can become a new, prevalent long-term condition. Our study also provides a rationale for investigating long-term COVID treatments with a precision medicine approach to target treatments to the individual patient profile to restore health-related quality of life.”
For interviews with the authors at the Institute of Lung Health and the National Institute for Health Research, Leicester Center for Biomedical Research, University of Leicester, UK, please email E) phosp@leicester.ac.uk
Alternate contact: Tony Kirby at ECCMID Press Centre. Tel) +44 7834 385827 H) tony@tonykirby.com
Notes to editors:
Lancet Respiratory MedicineClinical characteristics with pro-inflammatory profiling of COVID-19 and association with 1-year recovery after hospitalization in the UK: An observational study – presented in private session. Lancet Sunday 24th April 16.15-18.15 Lisbon/UK time (Western time zone).
click here View the press release in Spanish
click here View the press release in Portuguese
List of hospitals participating in this part of the study:
location |
NHS Trust |
Addenbrookes Hospital |
Cambridge University Hospitals |
Entry Hospital |
University Hospitals Liverpool NHS Foundation Trust |
Belfast City Hospital |
Belfast Health and Social Care Trust |
Castle Hill Hospital |
University of Hull Teaching Hospitals NHS Trust |
Glasgow Queen Elizabeth Hospital |
NHS Greater Glasgow and Clyde |
Glasgow Royal Infirmary |
NHS Greater Glasgow and Clyde |
Glenfield Hospital |
University Hospitals of Leicester NHS Trust |
Guy’s and St. Thomas Hospital |
NHS Guy’s and St Thomas’ Foundation Trust |
Hammersmith Hospital |
Imperial College Health Care NHS Trust |
Harefield Hospital |
Royal Brompton & Harefield NHS Foundation Trust |
Kings College Hospital |
NHS Foundation Trust for King’s College Hospital |
Wishaw University Hospital |
NHS Lanarkshire |
Manchester Royal Infirmary |
University of Manchester NHS Foundation Trust |
Ninewells Hospital and Medical College |
NHS Tayside |
North Middlesex Hospital |
NHS Trust for North Middlesex University Hospital |
Nottingham City Hospital |
University Hospitals of Nottingham NHS Trust |
Oxford Churchill Hospital |
Oxford University Hospitals NHS Foundation Trust |
Prince Philip Hospital |
Hywel Dda University Health Board |
Queen Elizabeth Hospital |
University Hospitals Birmingham NHS Trust |
The Royal Infirmary in Edinburgh |
NHS Lothian |
Rigmore Hospital |
NHS Heights |
Royal Brompton Hospital |
Royal Brompton & Harefield NHS Foundation Trust |
Royal Free Hospital |
Royal Free London NHS Foundation Trust |
Royal Joint Hospital |
Health Board of Anurin Bevan University |
Royal Hallamshire Hospital |
NHS Foundation Trust for Sheffield Teaching Hospitals |
Royal London Barts Hospital |
Barts Health NHS Trust |
Royal Papworth Hospital |
NHS Foundation Trust for the Royal Papworth Hospital |
Royal Victoria Clinic |
NHS Foundation Trust for Newcastle upon Tyne Hospitals |
Royal Salford Infirmary |
Salford Royal NHS Foundation Trust |
Southampton General Hospital |
University of Southampton Hospitals NHS Foundation Trust |
Southmead Hospital |
North Bristol NHS Trust |
St. George Hospital |
NHS Foundation Trust for St. George’s University Hospitals |
St. James University Hospital |
Leeds Teaching Hospitals NHS Trust |
St. Mary’s Hospital |
Imperial College Health Care NHS Trust |
Tamside General Hospital |
Tamside and Glosup Foundation for Integrated Care NHS |
Whittington Hospital |
Whittington Health NHS Trust |
University College Hospital |
University College London Hospitals NHS Foundation Trust |
Wythenshaw Hospital |
University of Manchester NHS Foundation Trust |
magazine
Lancet Respiratory Medicine
Article title
Clinical characteristics with protracted inflammatory profiling of COVID-19 and association with 1-year recovery after hospitalization in the UK: a prospective observational study.
The date the article was published
April 23, 2022
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