Recovered COVID-19 Patients Are Likely to Face These Longer-Term Issues

While the COVID-19 pandemic is likely to end at some point in the next year or so, the aftermath might linger much longer, according to a new study. Here are conditions that pharmacists and other healthcare professionals might expect to see in patients who recovered from severe cases of the novel coronavirus.

LEEDS, UK – When the novel coronavirus is finally under control, pharmacists and other healthcare professionals will have to deal with the clinical aftermath. A new study described what that might entail.

The report in the Journal of Rehabilitation Medicine advises that patients recovering from COVID-19 could suffer significant long-term effects, based on the experiences of patients who were hospitalized during previous coronavirus outbreaks.

Evidence on physical, psychological and social impacts among patients who recovered from Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), to previous coronaviruses, were compiled by researchers at the universities of Leeds, Manchester and Hull in the UK.

In the first six months, they report, patients faced respiratory and exercise capacity problems. In addition, mental health problems including post-traumatic stress disorder, anxiety and depression were identified in up to a third of survivors at six months and beyond. In fact, they point out, quality of life for one third of survivors was impaired even 12 months after hospital discharge.

To reach those conclusions, the study team searched Ovid MEDLINE, EMBASE, CINAHL Plus, and PsycINFO, including original studies on clinical outcomes of adult SARS and MERS survivors three months after admission or two months after discharge. Ultimately 28 studies were selected, and meta-analysis was used to derive pooled estimates for prevalence/severity of outcomes up to six months after hospital discharge, and beyond six months after discharge.

Pooled analysis revealed that common complications up to six months after discharge were: Impaired diffusing capacity for carbon monoxide (prevalence 27%, 95% confidence interval (CI) 15–45%), and reduced exercise capacity (mean 6-min walking distance 461 m, CI 450–473 m).

Researchers note that the following prevalences of mental health disorders beyond six months were considerable:

  • post-traumatic stress disorder (39%, 95% CI 31–47%),
  • depression (33%, 95% CI 20–50%) and
  • anxiety (30%, 95% CI 10–61) beyond 6 months after discharge were considerable.

“Lung function abnormalities, psychological impairment and reduced exercise capacity were common in SARS and MERS survivors,” the authors caution. “Clinicians should anticipate and investigate similar long-term outcomes in COVID-19 survivors.”

"COVID-19 is a new illness and the acute phase has already been devastating for people in many countries across the globe,” explained Manoj Sivan, MD, an Associate Clinical Professor and Consultant in Rehabilitation Medicine at the University of Leeds' Institute of Rheumatic and Musculoskeletal Medicine. "While we have all rightly been busy creating capacity in acute service and saving lives, we must not forget those being discharged from the hospitals. We don't really know the long-term health problems these survivors face in the recovery phase of this pandemic.”

Manoj points out, however, that the two previous coronavirus outbreaks can provide clinicians a rough idea of the rehabilitation needs in the first year after discharge.

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