Recently, “The Lancet” published online a cohort study jointly completed by Jinyintan Hospital, China-Japan Friendship Hospital Respiratory Center, National Respiratory Medicine Center, and Institute of Pathogenic Biology, Chinese Academy of Medical Sciences, to evaluate COVID-19 (new coronary pneumonia) ) Long-term effects on patients.
The subjects of this new study included 1,733 COVID-19 patients discharged from Wuhan Jinyintan Hospital between January 7 and May 29, 2020. The median age of the patients was 57 years. The follow-up time was from June 16, 2020 to September 3, 2020, and the median follow-up time was 186 days. The cohort study pointed out the long-term impact of COVID-19 infection on Jinyintan hospitalized patients in Wuhan, China. The most common persistent symptoms were fatigue or muscle weakness (63% of patients), and some patients often experienced sleep difficulties (26%) , Some also have anxiety or depression (23%).
Patients with severe illness have a higher prevalence of impaired lung function and abnormal chest imaging (which may indicate organ damage) within six months of the onset of symptoms. Six months later, among the 94 patients who underwent an immune response test during the peak of infection, the level of neutralizing antibodies dropped by more than half (52.5%), which raised concerns about the possibility of re-infection with the virus.
Researchers say that because COVID-19 is a new disease, little is known about the long-term health effects of COVID-19 because no follow-up studies have been conducted so far. During the short follow-up period (usually about three months after discharge), only a few cases were examined.
The study used questionnaires to conduct face-to-face interviews with all patients to assess their symptoms and health-related quality of life. The research team also conducted physical examinations, laboratory tests and a six-minute walk test to assess the patient’s endurance level. 390 patients underwent further examination, including assessment of their lung function. In addition, as part of another trial, 94 patients who had recorded blood antibody levels during the peak of the infection were followed up. At follow-up, 76% of patients reported at least one persistent symptom. According to reports, the proportion of fatigue or muscle weakness is 63%, while 26% of patients have difficulty sleeping, and 23% of patients have anxiety or depression.
Of the 390 patients who underwent additional tests, 349 completed pulmonary function tests (41 patients could not complete the test due to poor compliance). More severe patients usually show reduced lung function, and 56% of patients with a severity of 5-6 (requiring ventilation) experience a diffusion disorder-a decrease in oxygen from the lungs to the blood flow. For patients with severity level 4 (need oxygen therapy) and severity level 3 (no oxygen therapy required), the proportions were 29% and 22%, respectively.
More severe patients performed worse on the six-minute walk test (shown as a six-minute coverage distance), 29% of patients with a severity of 5-6 were smaller than normal, while those with a severity of 3 The number of patients was 24%, and the number of patients with severity 4 was 22%.
The researchers also found that some patients continued to have kidney problems after being discharged from the hospital. COVID-19 is known to affect other organs, including the kidneys. Laboratory tests showed that 13% of patients with normal renal function during hospitalization had abnormal renal function during follow-up.
A blood antibody test on 94 patients six months later showed that the level of neutralizing antibody was 52.5% lower than the peak of infection. Researchers say this raises concerns about the possibility of COVID-19 reinfection. Due to the limited number of participants who obtain antibody test results during follow-up, future work will require larger samples to clarify how antibody levels against the virus change over time.
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