More than half of Covid survivors still have symptoms two years on, study finds

New research on nearly 1,200 patients in China who were hospitalized in the first months of the pandemic shows that many continue to suffer from conditions such as sleep disorders and muscle weakness

Miguel Ángel Criado
A Covid-19 patient in Wuhan, China, on January 17, 2020.Wang He (Getty Images)

Some 55% of Covid-19 patients who were hospitalized in the first wave still have symptoms two years later. That’s according to a new study of patients in China that was published Tuesday in The Lancet Respiratory Medicine.

The paper studied hundreds of people who had been infected with the coronavirus in the first months of 2020 and needed to be hospitalized, some of them in intensive care. After being discharged, the patients were reviewed by doctors every six months for a period of 12 months. This makes it the longest follow-up study of Covid-19 survivors.

Nearly 1,200 patients took part for the entire duration of the two-year study. Of this figure, 68% had at least one symptom 18 months after being discharged from hospital. The figure dropped to 49% after one year, but rose back to 55% after the final review at the 24-month mark.

“Our findings indicate that for a certain proportion of hospitalized Covid-19 survivors, while they may have cleared the initial infection, more than two years is needed to recover fully from Covid-19,” said study lead author Professor Bin Cao, of the China-Japan Friendship Hospital, in a statement.

More than 200 symptoms have been described for long Covid. In the study, a third of the interviewees suffered from muscle weakness or fatigue, 25% had some type of sleep disorder and 12% suffered from a total or partial loss of hair. Loss of the sense of smell or taste, joint pain, palpitations, dizziness and myalgia were also among the most common symptoms, although they were reported by less than 10% of patients. Even though Covid is a disease caused by a respiratory virus, chest pain was the only notable related symptom on the list of symptoms. In most cases, two or more problems occurred simultaneously.

The follow-up shows that, with few exceptions, most symptoms ease over time. For example, more than half of those studied had muscle weakness at six months, a percentage that dropped by half at 24 months. The number of patients who reported problems with hair loss and anosmia (inability to smell) also fell. But the study found that other symptoms became more widespread between the first and second review. For example, the percentage of interviewees who suffered from myalgia and dizziness – while low to begin with – doubled in the six-month period.

These findings do not worry Joan Soriano, an epidemiologist at the Pneumology Department of La Princesa University Hospital in Madrid, who led the group of international experts that helped the World Health Organization reach the first definition of long Covid. “These inconsistencies in trends are common in follow-up studies, because some patients change for the better or worse between interviews, and the questionnaires are administered by different people and with different methods,” he says.

The study also leaves unanswered one of the most pressing questions for long Covid sufferers: when will the symptoms end?

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