COVID-19: The long road to recovery
Researchers have identified a pattern of longer-term symptoms likely to be experienced by people who were hospitalized with the COVID-19 infection.
They include fatigue, breathlessness, psychological distress—including problems with concentration and memory—and a general decline in quality of life.
Some patients, particularly those who had been in intensive care, had symptoms associated with cases of PTSD (post-traumatic stress disorder).
The findings provide the first detailed insight into problems facing patients recovering from COVID-19 in the UK.
Dr. Manoj Sivan, Associate Clinical Professor at the University of Leeds and a Consultant in Rehabilitation Medicine at Leeds General Infirmary, supervised the research project. He said: "COVID-19 is a new illness and we have very little information on longer term problems in individuals after discharge from hospital."
"The emerging evidence is that for some, the road to recovery may take months and it is vital specialist rehabilitation is on hand to support them. This research gives an important insight into patient needs, and that will help shape services in the community."
The findings—Post-discharge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation—have been published in the Journal of Medical Virology.
Dr. Stephen Halpin, Senior Research Fellow at the University of Leeds and Consultant with Leeds Teachings Hospitals NHS Trust, said: "This research follows our previous work of predicting COVID-19 patients' long-term needs based on previous coronavirus outbreaks of SARS in 2002 and MERS in 2012. The health problems are similar but on a larger scale given the number of people affected."
The research team—involving multidisciplinary specialists from the University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds Community Healthcare NHS Trust and Leeds Beckett University—followed 100 people recovering from COVID-19, four-to-eight weeks after being discharged from hospital in Leeds.
The COVID-19 survivors were divided into two groups: those who had become critically ill and needed intensive care—32 people were in this category; and those who were treated on a ward without needing intensive care—68 people were in this category.
Patients were contacted by a member of the hospital's rehabilitation team and asked a series of questions about their recovery and symptoms they were still experiencing.
The most prevalent symptom was fatigue. More than 60 percent of people who had been treated on a ward reported fatigue, and one-third of them described it as moderate or severe. For patients who had been in intensive care, 72 percent reported fatigue. Of those, more than half said it was moderate or severe.
The second most common symptom was breathlessness. People in both groups said they had feelings of breathlessness which had not existed before they contracted COVID-19. This was higher in the group that had been the most ill, the intensive care group versus those who had been treated in a ward—65.6 percent versus 42.6 percent.
The third most prevalent symptoms were neuropsychological. The research survey found that almost one quarter of the people who had been on a ward and just under a half of the people who had been in intensive care had some of the symptoms of PTSD.
Writing in the paper, the researchers said: "PTSD symptoms are a well-recognized component of post- intensive care unit syndrome caused by a variety of factors including fear of dying, invasive treatment, pain, delirium, inability to communicate, weakness, immobility, and sensory problems and sleep deprivation."
More than two-thirds (68.8 percent) of patients in the intensive care group and just under half (45.6 percent) of the other group said their overall quality of life had deteriorated.
The researchers say the rehabilitation needs of patients who did not require hospital care need to be further investigated and they are working on understanding this in future research.
More information: Stephen J Halpin et al, Post‐discharge symptoms and rehabilitation needs in survivors of COVID‐19 infection: a cross‐sectional evaluation, Journal of Medical Virology (2020). DOI: 10.1002/jmv.26368