7 in 10 patients hospitalized with Covid-19 not fully recovered five months post-discharge

The majority of survivors who left hospital following Covid-19 did not fully recover five months after discharge and continued to experience negative impacts on their physical and mental health, as well as their ability to work, according to results from the PHOSP-COVID (Post-Hospital Covid-19) study in which UCLH played a major role.

Furthermore, one in five participants reached the threshold for a new disability, according to the study which took place across 57 NHS hospitals, and analysed 1,077 patients who were discharged from hospital between March and November 2020.

UCLH was one of the top 10 recruiting sites in the study. UCLH authors, supported by the UCLH BRC, were Dr Michael Marks (UCLH Infectious Diseases and LSHTM) who is Co-Principal Investigator for UCLH and member of the national management group for PHOSP; Prof Jeremy Brown (UCL & UCLH Respiratory) and Co-Principal Investigator for UCLH; and Dr Joseph Jacob (UCLH radiology and UCL Respiratory). Prof David Lomas of UCLH and UCL Vice Provost (Health) co-chairs the PHOSP Steering Committee.

The study is led overall by the NIHR Leicester BRC. It is funded by the NIHR and UK Research and Innovation.

Each participant had an average of nine persistent symptoms. The ten most common were: muscle pain, fatigue, physical slowing down, impaired sleep quality, joint pain or swelling, limb weakness, breathlessness, pain, short-term memory loss, and slowed thinking.

In addition, 25 per cent of participants had clinically significant symptoms of anxiety and depression and 12 per cent had symptoms of post-traumatic stress disorder (PTSD) at their 5-month follow-up.

Of the 67.5 per cent of participants who were working before COVID, 17.8 per cent were no longer working, and nearly 20 per cent experienced a health-related change in their occupational status.

The researchers were able to the classify types of recovery into four different groups or ‘clusters’ based on the participants’ mental and physical health impairments. One cluster group in particular showed impaired cognitive function, or ‘brain fog’.

They also uncovered a potential biological factor behind some post-COVID symptoms. In all but the mildest cases of persistent post-Covid symptoms, levels of a chemical called C-reactive protein – associated with inflammation – were elevated.

More than 300,000 patients have been discharged from hospital following Covid-19. While PHOSP-COVID only represents a small sample of these patients, it is the largest study to report in detail on the impact of COVID-19 on medium term health.

Dr Marks said: “As well as guiding future research, these results demonstrate that we need to be able to offer patients experiencing the continued impacts of Covid-19 access to clinical services taking a holistic approach, considering mental health, memory and cognition and rehabilitation. We will continue to monitor participants taking part in the study with further results due at 12 months post-discharge.”

The pre-print title, yet to be peer-reviewed, is available on the preprint server medRxiv.org.