The study found that nearly half of the new crown rehabilitation patients were still accompanied by new crown sequelae one year after discharge. New crown sequelae (also known as long-term covid) refers to fatigue, forgetfulness, physical pain, sleep difficulties, hair loss, smell and taste disorders and other symptoms that last for a long time, of which the most common symptom is fatigue or muscle weakness.
Nearly half of the new crown rehabilitation patients have sequelae one year later
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In other words, it is impossible for some patients with new crowns to fully recover after 1 year. It takes longer for them to reach the baseline health status before infection with new crowns.
In this study, the researchers followed up 2218 new crown rehabilitation patients discharged from Wuhan Jinyintan hospital from January 7 to May 29, 2020, with a maximum follow-up time of 1 year.
During the 6-month and 12-month follow-up, the rehabilitated patients received questionnaires on symptoms and health-related quality of life (HRQOL), physical examination, 6-minute walk test and other index tests. Finally, 1276 covid-19 survivors completed two visits. The researchers also recruited participants who were not infected with the new crown as the control group. The control group was interviewed and completed a questionnaire to assess common symptoms and HRQOL.
When the researcher analyzed the data, the participants were divided into three groups according to the severity during hospitalization, which were grade 3 (no oxygen supplement is required); Level 4 (supplemental oxygen required) and level 5-6 (high flow nasal intubation, noninvasive mechanical ventilation or invasive mechanical ventilation required).
The main results of the study were new crown symptoms, patient dyspnea Rating Scale score (MMRC score), quality of life score and 6-minute walking distance (6MWD).
The results showed that 68% of the patients had at least one sequela 6 months after discharge (831 / 1227), and 49% had one or more sequelae 12 months after discharge. Fatigue or muscle weakness were the most frequently reported symptoms at the two visits.
In the total cohort and all three subgroups, fatigue or muscle weakness, sleep difficulties, hair loss, olfactory and taste disorders were significantly relieved over time. However, the proportion of patients with dyspnea (dyspnea) characterized by an MMRC score of 1 or more increased over time. At 6 months, the proportion of patients with dyspnea was 26% (313 / 1185), while at 12 months, the proportion increased to 30% (380 / 1271).
In addition, anxiety and depression also increased over time. The proportion of anxiety and depression was 23% at 6 months and 26% at 12 months. Most of them were mild anxiety or depression.
Next, the researchers further analyzed the health status of the rehabilitation patients according to the severity of the symptoms of the new crown.
After multivariable adjustment, participants with severity levels 5-6 had a higher risk of pulmonary diffusion disorder at 12 months than participants with severity levels 3. At 12 months, 23% (13 / 56) of patients in severity 3 group had pulmonary diffusion disorder, while 54% (38 / 70) in severity 5-6 group.
Diffusion dysfunction refers to the physical diffusion process in which O2, CO2 and other gases exchange through the alveolar membrane. Clinically, when pulmonary lesions produce diffusion dysfunction, its consequences lead to hypoxia. Pulmonary diffusion disorder can be attributed to lung epithelial injury or pulmonary interstitial or pulmonary vascular abnormalities.
This shows that the more severe the new crown is, the greater the damage to the lung, resulting in the slow recovery of lung health in the later stage.
