Healthy outcomes of patients with COVID-19 two years after the infection: a prospective cohort study

Abstract

The long-term effect of coronavirus disease 2019 (COVID-19) has been rarely known. This study aimed to investigate healthy outcomes of COVID-19 survivors up to 2 years after the infection. A total of 155 COVID-19 patients, who were discharged from Shenzhen Third People's Hospital from February 2020 to April 2020, were enrolled and followed up until March 4, 2022. COVID-19 survivors received questionnaires of long COVID symptoms and psychological symptoms, pulmonary function tests, chest computed tomography (CT) scans and routine laboratory tests. Two years after infection, 36.6% of patients had at least one symptom of long COVID. Vision impairment and fatigue were the most common symptom. 35.0% of participants still had at least one psychological symptom of anxiety, depression, post-traumatic stress symptoms, and sleep difficulties. Radiographic abnormalities were presented in 50.7% of patients, with the most common features of fibrosis-like lesions and residual ground-glass opacity. Diffuse dysfunction (24.0%) was the main abnormalities of pulmonary function tests. Most laboratory parameters returned to normal range, while persistent abnormalities in kidney and liver function test were observed in a subset of participants after discharge. Two years after COVID-19 infection, persistent symptoms of long COVID and psychological symptoms, as well as abnormalities in pulmonary function tests and CT, were still common in a subset of recovering individuals. These findings were limited by the lack of a healthy control group and pre-COVID assessments, which should be confirmed by further large-scale studies.

Factors Associated With Long COVID Symptoms in an Online Cohort Study

“…One prior study from 3 large cohorts identified that depression, anxiety, perceived stress, and loneliness measured before the pandemic were associated with post-COVID conditions, although we found that anxiety decreased after SARS-CoV-2 infection among those with and without Long COVID [ 29 ]. Our findings are consistent with studies which lack preinfection assessments that have found concurrent depression or anxiety to be associated with Long COVID symptoms [ 10 , 11 , 28 , 30 , 31 ]. Further research into mechanisms of how depression may be an antecedent factor to Long COVID are needed.…”

“…Most individuals with Long COVID were not hospitalized for acute infection, and Long COVID can occur regardless of illness severity, vaccination status, and SARS-CoV-2-targeted treatment [ 8 , 9 ], although the risk may be lower among vaccinated individuals and those with asymptomatic infection [ 9 , 10 ]. Symptoms have been reported for up to 24 months [ 11 ], and there are currently no proven treatments for Long COVID.…”

A systematic review and meta‐analysis of long‐term sequelae of COVID‐19 2‐year after SARS‐CoV‐2 infection: A call to action for neurological, physical, and psychological sciences

“…First domain (i.e., pre-COVID factors) describes risk factor present before SARS-CoV-2 infection and includes older age, female gender, higher BMI, and preexisting comorbidities (such as hypertension, diabetes, asthma, COPD, cardiac disease, chronic liver disease). 3,18,19,24,25 A conflicting report by Van Wambeke et al 26 showed that comorbidities did not correlate with long COVID, but rather with greater return to work. The second domain (i.e., COVID-related factors) describes risk factors present during acute infection with COVID-19 and includes severe infection, 3 and increased symptom burden.…”

Factors Associated with Long Covid Symptoms in an Online Cohort Study

“…29 Our findings are consistent with studies that lack pre-infection assessments that have found concurrent depression or anxiety to be associated with Long COVID symptoms. 10,11,28,30,31 Further research into mechanisms of how depression may be an antecedent factor to Long COVID are needed. Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), may have protective effects in acute SARS-CoV-2 infection, 32,33 but understanding whether treatment with antidepressants or naltrexone 34…”

“…[2][3][4][5][6][7] Most individuals with Long COVID were not hospitalized for acute infection, and Long COVID can occur regardless of illness severity, vaccination status, and SARS-CoV-2-targeted treatment, 8,9 although the risk may be lower among vaccinated individuals and those with asymptomatic infection. 9,10 Symptoms have been reported for up to 24 months, 11 and there are currently no proven treatments for Long COVID.…”