Follow-up of 1733 patients with Jinyintan new crown: more than 70% have at least one symptom after half a year
One year after the outbreak of the new coronavirus, the epidemiological and clinical features, pathogenesis, and complications of patients in the acute phase have been clearly described in previous studies, but the long-term consequences of the disease are still largely unclear.
On January 9, Beijing time, the top medical journal "The Lancet" published online research conducted by Wuhan Jinyintan Hospital, Respiratory Center of China-Japan Friendship Hospital, National Respiratory Medicine Center and Institute of Pathogen Biology, Chinese Academy of Medical Sciences A study jointly completed by the team, entitled "6-month consequences of COVID-19 in patients discharged from hospital: a cohort study".
The study evaluated the impact of COVID-19 on the long-term outcome of patients, and found that more than 3/4 (76%) of patients still had at least one persistent symptom 6 months after the onset.
Fatigue and muscle weakness are the most common symptoms, and sleep disorders, anxiety and depression also frequently occur.
Professor Cao Bin, deputy dean of the China-Japan Friendship Hospital, Zhang Dingyu, dean of Wuhan Jinyintan Hospital, and Wang Jianwei, deputy dean of the Chinese Academy of Medical Sciences and Peking Union Medical College (abbreviated as college) are the co-corresponding authors of the study.
In an interview with The Lancet, Cao Bin said, “Because COVID-19 is a new disease, we have only just begun to understand its long-term impact on patients’ health. Our follow-up studies show that most patients are discharged from the hospital. It will continue to be at least partially affected by the virus in the future, and medical care after discharge is very necessary, especially for patients who are more severely ill during hospitalization. Our research also suggests a longer-term follow-up study in a larger population In order to understand the overall impact of the disease on the human body.” The study was selected among COVID-19 patients discharged from Wuhan Jinyintan Hospital from January 7 to May 29, 2020, with a median age of 57 years. The median follow-up time was 186 days after onset.
During the period from June 16 to September 3, 2020, the research team completed a intensive follow-up of 1733 patients.
The study conducted face-to-face interviews with all patients and assessed their symptoms and health-related quality of life through a series of questionnaires.
These patients also underwent physical examinations, laboratory tests, and a 6-minute walk test to assess patient endurance levels.
Among them, 390 patients underwent further examinations including lung function assessment.
In addition, 94 patients who participated in another clinical trial (LOTUS China) and completed the acute-phase SARS-CoV-2 antibody test will be tested again during follow-up.
The study found that 76% (1265/1655) of patients reported still having at least one symptom at follow-up, 63% (1038/1655) of patients reported fatigue or muscle weakness, and 26% (437/1655) of patients had sleep disorders , 23% (367/1733) of patients reported anxiety or depression.
Among the 390 patients who underwent pulmonary function tests, 41 cases were unable to complete the pulmonary function tests. Finally, 349 cases completed pulmonary function tests.
Pulmonary function decline is more common in patients with more severe illness during hospitalization: Among patients with a 7-level scale score of 5-6 (receiving mechanical ventilation during hospitalization), 56% (48/86) have diffuse pulmonary dysfunction , Which means that the diffusion capacity of oxygen from the alveoli to the bloodstream is reduced.
The proportion of patients with diffuse pulmonary dysfunction who scored 4 points on the 7-level scale (receiving oxygen therapy during hospitalization) was 29% (48/165), and the proportion of patients who scored 3 points (not receiving oxygen therapy during hospitalization) was 22% %(18/83).
Patients who were more severely ill during hospitalization performed worse in the 6-minute walk test (measuring the distance the subject walked in 6 minutes), and 29% of patients with a 7-level scale score of 5-6 did not meet the expected value The lower limit of the ratio is 24% in 3 points and 22% in 4 points.
The study also found that some patients had kidney problems after being discharged from the hospital.
In addition to the lungs, COVID-19 can also affect other organs including the kidneys.
Laboratory examination found that 13% (107/822) of patients with normal renal function at hospitalization had abnormal renal function at follow-up.
It is worth noting that 94 patients completed the antibody test during follow-up, and compared with the acute hospitalization, the titer of neutralizing antibody dropped by 52.5%.
The research team said that this may raise concerns about the risk of reinfection.
In response to the limitations of the study, the research team mentioned that due to the limited number of patients who completed antibody testing during the acute phase and follow-up in this study, a larger sample of studies is needed in the future to illustrate the dynamic trend of antibody changes over time.
In addition, because mild patients were treated intensively in Fangcang shelter hospitals during the Wuhan epidemic, this study failed to enroll mild patients. Therefore, it is necessary to conduct further research to compare the long-term outcome differences between outpatient mild patients and inpatients.
The Paper Journalist He Liping