Long COVID is common years after being hospitalised

From: The Lancet

The Lancet Psychiatry: Severity of depression, anxiety and fatigue may increase in some individuals up to three years post-hospitalisation with COVID-19 compared to six months after, study suggests

The severity of depression, anxiety, and fatigue in some people is significantly higher two to three years after hospitalisation with COVID-19 compared to six and/or 12 months after, with evidence of both worsening of existing symptoms and emergence of new symptoms, suggests a study of 475 participants from the PHOSP-COVID cohort. At two to three years post-hospitalisation, most participants reported at least mild symptoms of one or more of depression, anxiety, fatigue and cognitive decline (such as memory loss or trouble with language), with more than one in five reporting severe symptoms. Emergence of new symptoms were mostly seen among people who experienced some other symptoms at 6 months. The authors believe this might indicate a window of opportunity for early intervention on core symptoms to prevent the emergence of a more complex syndrome.

More than one in four participants reported having changed their occupation compared to before they had COVID-19, and the main reason given was poor health. The study, published in The Lancet Psychiatry, also found an association between occupation change and an increase in cognitive deficits, but not depression or anxiety. Authors say this suggests many people who changed occupation in the months and years after hospitalisation with COVID-19 did so because they could no longer meet the cognitive demands of their job rather than for lack of motivation, interest, or confidence.

Authors highlight several limitations in this study, including a low response rate (19.2% of the PHOSP cohort responded to this survey) meaning a risk of selection bias where those who replied may be more likely to have symptoms than those who did not respond. Additionally, as those in the PHOSP cohort were hospitalised with COVID-19, the study findings might not generalise to patients who were not hospitalised.

The Lancet: More research is needed to better understand, treat, and prevent long COVID, says Review  

A new, interdisciplinary Review of long COVID (also known as post-COVID-19 condition) explores the different facets of this emerging condition –  from its epidemiology and clinical manifestations to lived experiences and current best practices for managing long COVID and priorities for future research. The authors acknowledge that there are many challenges and unknowns for clinicians and patients alike when managing long COVID, as uncertainties about how to define, diagnose, and manage the condition remain. However, the review, published in The Lancet, suggests the recent advances in clinical phenotyping, deep molecular profiling, and biomarker identification could lead to a more informed and personally tailored approach to clinical care, with suggestions for future research focused on clinical trials and studies exploring potential treatments, next-generation COVID vaccines, developing predictive biomarkers for people who are more likely to develop long COVID, and optimizing rehabilitation protocols and health services to provide better support for people diagnosed with long COVID.

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