Significant number of Covid-19 patients have ‘ongoing symptoms’ after hospital

A “significant” proportion of Covid-19 patients admitted to hospital will still suffer adverse symptoms three months after being sent home, a new study has suggested.

Breathlessness, fatigue, anxiety, depression and limited ability to do exercise are felt by many two to three months after they were infected with the new coronavirus, the research shows.

And MRI scans have revealed that many are left with abnormalities in the lungs, heart, liver and kidneys.

Scans also revealed changes in the brain which were coupled with “impaired cognitive performance”, scientists said.

Coronavirus graphic
(PA Graphics)

Those who had poor exercise performance and abnormalities detected in their MRI scans were also more likely to show markers for inflammation in their blood – which the researchers said could mean there is a potential link between chronic inflammation and ongoing organ damage among survivors.

Researchers from the University of Oxford set out to examine the medium-term effects of Covid-19 on 58 people admitted to hospital, compared with 30 people who have not been affected by the virus.

The participants underwent magnetic resonance imaging (MRI) of their brain, lungs, heart, liver and kidneys; spirometry to test their lung function; a six-minute walk test; cardiopulmonary exercise test, as well as assessments of their quality of life, cognitive and mental health.

Two to three months after they first showed symptoms, 64% still suffered persistent breathlessness and 55% has significant fatigue.

MRI scans showed abnormalities in the lungs of 60% of those who had been admitted to hospital with Covid-19.

A quarter (26%) had damage to heart tissue, and 10% showed signs of liver damage while 29% had kidney abnormalities.

Researchers also detected tissue changes in the brain and the participants also “demonstrated impaired cognitive performance, specifically in the executive and visuospatial domain relative to control”.

Patients were also more likely to report moderate to severe anxiety and depression as well as significant impairment to their quality of life.

Covid-19 patients also showed “significantly reduced” exercise tolerance, they added.

The scientists said that the abnormalities detected on MRI scans and reduced exercise capacity in patients  was correlated with markers of inflammation.

They said that this suggests a potential link between chronic inflammation and ongoing organ damage.

The paper, published as a pre-print on MedRxiv, concluded: “A significant proportion of Covid-19 patients discharged from hospital experience ongoing symptoms of breathlessness, fatigue, anxiety, depression and exercise limitation at two to three months from disease-onset.

“Persistent lung and extra-pulmonary organ MRI findings are common.

“In Covid-19 survivors, chronic inflammation may underlie multiorgan abnormalities and contribute to impaired quality of life.”

Co-lead of the study, Dr Betty Raman, a clinical research fellow at the Radcliffe Department of Medicine, said: “Our study assessed patients recovering from Covid-19 following hospitalisation, two to three months from disease onset.

“Whilst we have found abnormalities in multiple organs, it is difficult to know how much of this was pre-existing, and how much has been caused by Covid-19.

“However, it is interesting to see that the abnormalities detected on MRI and exercise capacity in patients strongly correlated with serum markers of inflammation. This suggests a potential link between chronic inflammation and ongoing organ damage among survivors.

“These findings underscore the need to further explore the physiological processes associated with Covid-19 and to develop a holistic, integrated model of clinical care for our patients after they have been discharged from hospital.

“We would like to thank all our patients and their families who have taken part in this study. In helping us to better understand the effects of this new disease, they have made an important contribution in helping others who have contracted – and who will contract – the virus.”

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