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Infectious Diseases

Updated 20 July 2020

Most survivors of severe Covid-19 report symptoms many weeks after 'recovery', study shows

In Italy, many severe Covid-19 survivors were found to be dealing with issues like fatigue and shortness of breath weeks after their discharge.

  • Survivors of serious Covid-19 may struggle with after-effects of the disease for weeks after their release from hospital
  • Almost 90% of a group of Italian survivors reported persistence of at least one symptom
  • A research team found that patients need continued monitoring after discharge

Even a month after hospital discharge and "recovery", a majority of patients who had survived severe Covid-19 were still dealing with fatigue, shortness of breath and other symptoms, Italian research shows.

The study tracked outcomes for 143 hospitalised patients treated in April in Rome, at the height of the Italian Covid-19 pandemic.

They'd spent an average of about two weeks under hospital care, and one-fifth had required some form of respiratory support, said a team led by Dr Angelo Carfi, of the Policlinic Foundation University Agostino Gemelli, in Rome.

Assessed an average of five weeks after discharge, few of these survivors could say that their lives and health had returned to normal. In fact, "87.4% reported persistence of at least one symptom", most typically fatigue (53% of patients) or a troubling shortness of breath (43%).

Continued monitoring needed

Other lingering symptoms included joint pain (about 27% of patients) and chest pain (nearly 22%), Carfi's group reported on 9 July in the Journal of the American Medical Association.

Only about 13% of all of the recovering patients said they were free of symptoms at 36 days after discharge: About one-third said they had one or two symptoms and more than half (55%) said they suffered three or more.

Based on the findings, Carfi's team said that "clinicians and researchers have focused on the acute phase of Covid-19, but continued monitoring after discharge for long-lasting effects is needed".

That notion was seconded by one US expert who's seen his share of Covid-19 patients. Dr Robert Glatter is an emergency medicine physician at Lenox Hill Hospital in New York City, the early epicentre of the US pandemic.

"The harsh reality is that many patients continue to experience lingering symptoms for weeks and months after being diagnosed with and 'recovering' from Covid-19," Glatter said.

A mental health toll as well

Why that happens remains unclear, he said, but "one theory is that Covid-19 leads to a state of chronic inflammation", as can happen with viral infections such as Epstein-Barr.

"While this small study found that fatigue and shortness of breath were the two most common symptoms, many people also experience many other lingering symptoms including low-grade fevers, and neurologic symptoms such as numbness and tingling," Glatter noted.

Covid-19 takes a mental health toll, as well, he said.

"'Long haulers' also must deal with issues of depression and anxiety, making the disease not only physically but emotionally disabling," Glatter said.

"The bottom line is that we need to pay attention to those individuals with ongoing symptoms and pursue research to address the underlying mechanism of such symptoms," he concluded.

Image credit: Getty Images