An Oxford University study looking at the longer-term impact of Covid-19, so-called “long Covid”, has concluded that a large proportion of Covid-19 patients discharged from hospital are still experiencing symptoms of breathlessness, fatigue, anxiety and depression two to three months after contracting the virus.
The scientists carrying out the C-MORE study also detected abnormalities on magnetic resonance imaging (MRI) in multiple organs and have argued that persistent or chronic inflammation may be an underlying factor for these changes among Covid-19 survivors.
There are growing worries that long Covid could become a significant return-to-work challenge for occupational health practitioners. Research has suggested as many as one in 20 go on to develop long-term symptoms following catching the virus, with older women at most risk. The NHS is also establishing a network of specialist clinics to treat, and try to better understand, the condition.
The Oxford University study took 58 patients with moderate to severe laboratory-confirmed Covid-19, who had been admitted for treatment at the Oxford University Hospitals NHS Foundation Trust between March and May 2020.
The researchers also recruited 30 uninfected controls from the community, group-matched for age, sex, body mass index and risk factors such as smoking, diabetes and hypertension.
The participants underwent an MRI of their brain, lungs, heart, liver and kidneys; spirometry to test their lung function; a six-minute walk test; cardiopulmonary exercise test (CPET), as well as assessments of their quality of life, cognitive and mental health.
The study found that two to three months after the onset of the disease, 64% of patients experienced persistent breathlessness and 55% complained of significant fatigue.
On MRI, tissue signal abnormalities were seen in the lungs of 60% of the Covid-19 patients, in the kidneys of 29%, in the hearts of 26%, and the livers of 10%. Organ abnormalities were seen even in patients who had not been critically ill when admitted.
The scans also detected tissue changes in parts of the brain, and patients demonstrated impaired cognitive performance. Their ability to sustain exercise was also significantly reduced, although this was due to a combination of fatigue and lung abnormalities.
The study found patients were more likely to report symptoms of anxiety and depression, and a significant impairment in their quality of life compared to the controls.
Study co-lead Dr Betty Raman, of the Radcliffe Department of Medicine, said: “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.”
Separately, the National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP) have said they are developing guidelines on long Covid, or what they are terming “post-Covid syndrome”.
A guideline scope document was published in October, which defined post-Covid syndrome as “signs and symptoms that develop during or following an infection consistent with Covid-19 which continue for more than 12 weeks and are not explained by an alternative diagnosis.”
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The condition usually presented with clusters of symptoms, often overlapping, which may change over time and could affect any system within the body. “Many people with post-Covid syndrome can also experience generalised pain, fatigue, persisting high temperature and psychiatric problems,” it added.
The full Oxford University paper can be found here.
4 comments
i had covid at the beginning of the pandemic,there were no testing ,i was sent home with antibiotics ,told that one of my lungs was full of pneumonia and the other lung was affected as well.The dr told me the pneumonia was part of the covid ,so they were sure i was covid positive.I felt so very unwell,it took me off my feet for at least 3 months.
actually thought that once the antibiotics had kicked in ,i would feel better,I I DIDNOT!!!!!!!!!!!!
however,no one seems to want to acknowledge the fact that i feel so unwell still ,the gp wont see you,even the lung specialist did a telephone consultation,and that was to discuuss all the damage that had happned to my lungs.the thing is,talking on the phone is so impersonal,How can a medical proffessional assess you without even looking at you!!!!!
i can not walk far,so i need a wheelchair ‘just in case’ as when we are out i can be ok one minute then the next im pooped,and can not do anything , i just wanted to share this,because how am i ever going to know or have my medical state acknowledged!
oh and a shout out to all those wonderful gp receptionists who make you feel absolutely frustrated,and will not budge an inch on the phrase ,there are no other appointments left\
my lungs are so damaged,i have all sorts going on that i dont understand, what the hell is bud in tree type lobes? inflamation,,blood filled pockets,ect ect .,it all means nothing to me..
so you find that you feel that you and the way you feel so unwell means nothing to others!
even in the gp surgery ,no receptionist is atall interested in how you feel,and not one receptionist wears a mask. they dont know if they are covid free,so surely they should be .
i asked if they think they should be wearing ppe ,but they just say in their haughty taughty manner ,we dont need to we’ve been tested .YES SO HAVE I!!!!i have antibodies,so why wont the gp see me!
COVID does not just affect when you have it!!!! it carrys on ruining your abilty to function normaly ,Lead a happy fullfilled life,i have no energy to do the things i use to take great pleasure in..i have horses,and i stupidly fell off and broke my back in 2017,and that ended up in me contracting mrsa,and i spent many weeks in and out of hospital,haveing wounds washed out ,i ended up haveing a large chunk of muscle tissue removed, and i fully remember the moment i felt better, it was the day after yet another long complicated operation,but i just thought i am not giveling in any more i have to be well.
i have a fantastic network of support in the way of friends ,and field friends, and my horses,husband ect,i am a foster carer,which is just as well,as i would not be able to go back to work! but i feel i am not giveing the boys in my care everything they need.
so my whole point is this ,what is going to be put in place for x covid sufferers? who is going to be there to see us face to face,
but they are going home to family ect
Yes, i am sorry for yours condition, am not in a bad state like you, but i suffering from long covid for five months now, and i have a lot frustration in try to find a proper help
Or is long covid caused by 5G, which has for some reason been rolled out this year, when we are all meant to be locked down, the 5G quietly rolls into your area.
Wow! Ann Marie I hope you see this message. I woke up one morning gasping for air, then the next and the next. Tested negative. Dialled 111 they told me to go to A and E. Some twisted nurse unhappy that I came in walking touched a thermometer before putting it in my mouth and I have had covid in my gut ever since and that was 8 months ago. It’s amazing how many doctors have tried to give me antibiotics. It’s a virus! They are doctors! They know that it will do more harm than good! My only conclusion is that losing family freinds and loved ones has made people twisted. It’s really not a nice time to be alive. you cant trust anybody. And the people you cant trust the most are the people you should be able to trust the most. Your doctor.
Just know Anne Marie that you are not alone, trying to find help I saw so many people worse on antibiotics and even worse having their appendix removed for covid in their gut. It’s a national disgrace that many (not all) health workers have not done their homework.