Half of the first hospitalized for coronavirus still have symptoms two years later

Admission of one of the first infected with coronavirus at the Jin Yintan hospital in Wuhan, China, on January 17, 2020. By then, only two people had died. Wang He (Getty Images)

55% of those first infected with the coronavirus who had to be hospitalized continue, two years later, with one or more symptoms of covid.

The follow-up of those infected at the beginning of the pandemic in Wuhan (China) shows, however, that the number and intensity of the problems have improved.

Topping the list is muscle fatigue or weakness, sleep problems, and hair loss.

Between 12 and 24 months, the study detected a reactivation of most of the sequelae.

As time passed and many people recovered from covid, the evidence grew that many of them were cured, but did not recover.

With no trace of the coronavirus in his body, they reported dozens of different symptoms that he was in there.

From loss of smell to mental fog, through palpitations or joint pain, many of those affected were shaping what is now called persistent covid syndrome.

Although much is known about this painting, the time question remains to be cleared up: how long does it last?

When do problems subside?

Why do some stay and not others?

Researchers from various Chinese scientific institutions have been following the evolution of several hundred people who were infected in the first months of 2020 since the beginning of the pandemic. Since they went through the hospital, many in intensive care or assisted with artificial respiration, doctors they have been interviewed, subjected to various physical tests, and even had their lungs or brains scanned.

The follow-ups were made at six months after discharge and at 12 months.

Now, the medical journal

publishes the results of the visits made at 24 months.

It is, therefore, the work that has gone the furthest and allows a good characterization of what persistent covid is.

“Although they may have eliminated the initial infection, a certain number of Covid survivors who were hospitalized need more than two years to fully recover”

Bin Cao, professor at the China-Japan Friendship Hospital and head of the Wuhan study

Beijing-based China-Japan Friendship Hospital professor Bin Cao is the lead author of this follow-up.

In a note he says: "Our findings indicate that, although they may have eliminated the initial infection, a certain number of Covid survivors who were hospitalized require more than two years to fully recover."

Specifically, of the almost 1,200 who have participated in the study all this time, 68% had at least one symptom 18 months after discharge.

The percentage dropped to 49% at the end of the year, but rose again to 55% the last time they were reviewed, at 24 months.

For persistent covid, more than 200 symptoms or sequelae have already been described.

In the case of this sample from Wuhan, all affected by the Alpha variant of the coronavirus, a third of the interviewees suffered from muscle weakness or fatigue, 25% had some sleep disorder and 12% suffered from a total or partial loss of sleep. hair.

Among the 10 most common symptoms, and all under 10% of cases, there are also disorders of smell or sense of taste, joint pain, palpitations, dizziness or myalgia.

Even though covid is a disease caused by a respiratory virus, the only notable related symptom on the list is chest pain.

In most cases, two or more problems occur simultaneously.

The follow-up shows that, with few exceptions, most of the symptoms subside with the passage of time.

For example, more than half of those studied had muscle weakness at six months, a percentage that drops to half at 24 months.

Similar reductions occur with problems with hair and smell.

But there are other sequels that increase between the first review and the second.

Thus, the percentage of people with sleep disorders remains the same, around 25% of those interviewed.

And there are other symptoms, such as myalgia or dizziness that, although with low starting figures, are doubled.

These increases do not worry Joan Soriano, an epidemiologist at the Pneumology Service of the Hospital Universitario de La Princesa in Madrid, who led the group of international experts who agreed for the World Health Organization on the first definition of persistent 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 methods," he says.

Regarding the results themselves, he comments that “in Spain we are seeing practically the same thing”.

Here, "fatigue, shortness of breath and cognitive problems (brain fog) are the three most frequent," he adds.

For Soriano, it is important to note that this entire list of symptoms is repeated with other variants of SARS-CoV-2,

“There are other respiratory viruses that have subsequent symptoms that last three, four or five months.

There was hope that the coronavirus would behave like this and it is not doing so.

Pilar Rodríguez Ledo, Vice President and Head of Research of the Spanish Society of General and Family Physicians

Dr. Pilar Rodríguez Ledo, Vice President and Head of Research at the Spanish Society of General and Family Physicians (SEMG), is cautious about extrapolating the results of this study to the situation in other countries such as Spain.

"First, because they are patients of the first wave with a high viral load and few defenses," she says.

In addition, there is the cultural factor.

Many of the symptoms are self-reported and can vary between people of different work cultures.

For example, despite their health problems, 98% of those investigated at the Wuhan hospital have returned to their pre-pandemic job.

"But this work is very valuable: beyond the sequelae of a serious acute illness, symptoms appear that are maintained over time," she comments.

Throughout this article, the terms sequelae and symptoms have been used synonymously, when in fact they are not.

The dictionary of the Royal Academy of Language considers the first consequences of a disease and the second as manifestations of a pathology.

Rodríguez Ledo speaks of the former as “scars, subsequent symptoms of an organic injury”.

But here what is there is “a persistence of symptoms in the absence of that injury, but they are a limiting condition.

With the coronavirus they intermingle.”

When will these symptoms or sequelae disappear?

It is the question asked by many of those affected.

The study authors don't have the answer.

But they bring to mind the case of the SARS epidemic of 2002. Then, a similar follow-up showed that chronic fatigue continued four years after being cured.

“There are other respiratory viruses that have subsequent symptoms that last three, four or five months.

The difference is that they are self-limited in time, they disappear after a few months”, recalls the SEMG research manager.

“There was hope that the coronavirus would behave like this and it is not.

Yes, there is remission, but it can also be a mere adaptation to the new situation and it is very difficult to call it a cure”, she concludes.

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