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Risk factors tied to Long COVID up to 7 months after hospital release

Female sex, middle age, two or more chronic diseases, and more severe initial illness were predictive of difficulty recovering from COVID-19 six months after release from a hospital, according to a multicenter study in the United Kingdom and published in The Lancet Respiratory Medicine.

University of Leicester researchers led the study, which involved an assessment of 1,077 adults 2 to 7 months after release from the hospital for treatment of COVID-19. The patients left the hospital from Mar 5 to Nov 30, 2020.

After a median of 5.9 months of follow-up, 29% of 830 participants said they felt fully recovered, while 20% had a new disability and 19% had to change jobs due to their health. 

Researchers identified four clusters involving 767 patients with different degrees of coronavirus-related mental and physical impairment. Seventeen percent had very severe impairments, 21% were severely affected, 17% had moderate impairment with cognitive problems, and 46% were mildly impaired.

Three percent of 113 patients in the very severe group reported feeling fully recovered, as did nine of 129 (7%) in the severe cluster, 36 of 99 (36%) in the moderate group, and 114 of 267 (43%) in the mild cluster. 

Persistently increased serum C-reactive protein (indicating inflammation) was positively associated with impairment severity. The degree of physical and mental—but not cognitive—impairments were also closely associated with each other. The authors said that the findings suggest the presence of underlying mechanisms, regardless of the degree of lung injury and perhaps related to lingering systemic inflammation.

The World Health Organization (WHO) has released an official clinical definition for long covid. According to the WHO, “Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis. 

Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.” More here.

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Dr. Melvin Sanicas (@Vaccinologist) is a physician-scientist specializing in vaccines, infectious diseases, and global health. 

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