COVID Patients Retain Symptoms

Half of patients hospitalized with COVID-19 still have at least one symptom two years after their initial infection, a study published Wednesday found.

Among those infected with the original strain of the virus that causes COVID-19 in Wuhan, China, many were in poor health and had lower quality of life long after recovering from the illness, data published by the Lancet Respiratory Medicine showed.

Although physical and mental health generally improved over time, the assessment of nearly 1,200 people hospitalized following their initial infection typically experience symptoms such as fatigue, shortness of breath and sleep problems up to two years later, the researchers said.

The findings suggest a high percentage of those sickened suffer from "long COVID," they said.

"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," study co-author Bin Cao said in a press release.

"Ongoing follow-up of COVID-19 survivors, particularly those with symptoms of long COVID, is essential to understand the longer course of the illness," said Cao, of the China-Japan Friendship Hospital.

Previous research has indicated that as many as 60% of those with COVID-19 experience persistent symptoms, or long COVID, for up to a year, while only one in four is fully recovered in that time.

The findings of this study are based on health evaluations of 1,192 adults with acute COVID-19 treated at Jin Yin-tan Hospital in Wuhan, China, between Jan. 7 and May 29, 2020, the researchers said.

Participants were evaluated at six months, 12 months and two years after their recovery from initial illness. Assessments involved a six-minute walking test, a commonly used measure of strength and energy, as well as blood tests, and questionnaires on symptoms and mental health, researchers said.

Study participants also were asked if they had returned to work and about their healthcare use after hospital discharge.

Six months after initially falling ill, 68% of the participants reported at least one long COVID symptom, the data showed. By two years after initial infection, that number had declined, but only to 55%.

Fatigue or muscle weakness were the most common long-term symptoms, reported by 52% of participants at six months following recovery and by 30% at two years, according to the researchers.

Among just under 500 participants of working age, 89% had returned to work within two years after their recovery, the data showed.

Still, 31% of the participants reported having sleep problems two years after recovering from COVID-19, the researchers said.

Patients who had been hospitalized with COVID-19 also were more likely to report joint pain, palpitations, dizziness and headaches, as well as depression and anxiety two years after their initial illness than those who were not infected with the virus, according to the researchers.

About 55% of the previously infected study participants had symptoms of long COVID, or persistent illness, two years after their initial illness and reported lower quality of life than those without long COVID, the data showed.

Among long COVID sufferers, 13% had symptoms of anxiety, while 11% had depression symptoms, the researchers said.

"There is a clear need to provide continued support to a significant proportion of people who've had COVID-19, and to understand how vaccines, emerging treatments, and variants affect long-term health outcomes," Cao said.

Although it is unclear why some people experience long-term symptoms from COVID-19, a separate study published Wednesday by the journal GeroScience found that some of those who test positive for the virus continue to do so for more than two weeks.

Patients who "shed" the virus for two weeks or more following their initial positive test are more likely to experience delirium, or confusion, as well as have longer hospital stays, compared with those who tested negative after a few days, the data showed.

They were also more likely to die within six months of getting infected, the researchers said.

Among 959 study participants who underwent repeat COVID-19 testing for at least 14 days from their initial positive result, 405, or 42%, were found to have persistent viral shedding, according to the researchers.

Of these persistent shedders, 54% were men and 56% experienced in-hospital delirium, the primary neurologic complication of COVID-19, they said.

"These patients were much more likely to have been delirious while they were hospitalized," study co-author Dr. Eric Liotta said in a press release.

"This ... suggest[s] that patients who are delirious during hospitalization are more likely to have long-term cognitive issues and may experience accelerated cognitive decline with aging," said Liotta, a neurocritical care specialist at Northwestern Medicine in Chicago.

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COVID Patients With Brain Complications

More than one in 10 people hospitalized with COVID-19 develop "serious" neurological symptoms, a study published Wednesday found.

About 13% of patients hospitalized due to the virus experienced neurological, or brain- and nervous system-related, symptoms, including strokes and seizures, data published Wednesday by the journal Critical Care Explorations showed.

The most common brain-related COVID-19 complication was encephalopathy, or brain damage that causes a decline in cognitive function, which occurred in 10% of hospitalized patients, the researchers said.

"Our findings show that encephalopathy at hospital admission is present in at least one in 10 patients with [COVID-19] infection," study co-author Dr. Anna Cervantes-Arslanian said in a press release.

"Stroke, seizures and meningitis and/or encephalitis were much less common," said Cervantes-Arslanian, an associate professor of neurology, neurosurgery and medicine at BostonUniversity.

The findings are based on an analysis of medical records for more than 16,000 patients from 179 hospitals in 24 countries sickened during the first year of the COVID-19 pandemic.

Nearly 13% of patients admitted to hospitals included in the study for COVID-19 in the first year of the pandemic developed serious

Just over 10% had encephalopathy, or any disease of the brain that alters brain function or structure, at hospital admission, while 2% had evidence of a stroke, the researchers said.

About 2% suffered from seizures related to the virus while just under 1% had meningitis, or inflammation in the membranes that protect the brain and spinal cord, or encephalitis, or inflammation in the brain, at admission or during hospitalization, according to the researchers.

Patients who experienced neurological complications with COVID-19 were at higher risk for severe illness from the virus, including the need for intensive care unit treatment and ventilator support to maintain breathing, as well as longer hospital stays, the researchers said.

They also were more likely to die from the virus, the data showed.

A history of stroke or neurological disorders increased patients' risk for brain complications related to COVID-19, the researchers said.

Black patients with COVID-19 were more likely to suffer strokes, seizures and/or encephalopathy compared with White patients, according to the researchers.

Previous studies have shown that even in mild cases the virus causes inflammation in multiple organ systems, including the brain and nervous system, leading to problems with organ function.

"Given the association of neurologic manifestations with poorer outcomes, further study is desperately needed to understand why these differences occur and what can be done to intervene," Cervantes said.

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