Reduced lung function, poor mobility and PTSD 'common' four months after COVID patient leaves hospital, study suggests

Alexandra Thompson
·5 min read
Cropped shot of a senior woman using a walking stick at home
Older coronavirus patients who were ill enough to be hospitalised may endure reduced lung function and poor mobility after being discharged. (Stock, Getty Images)

Older people who were hospitalised with the coronavirus “commonly” endure complications four months after being discharged, research suggests.

Tens of thousands of people in the UK alone are said to be enduring long COVID; when symptoms like fatigue, palpitations and even organ damage persist after a former coronavirus patient tests negative.

While long COVID can affect people with a relatively mild bout of the infection itself, medics from the University of Eastern Piedmont in Italy analysed 219 adults aged 50 to 71 who were ill enough to be admitted to hospital between March and June 2020.

Results reveal it was common for the participants to be experiencing reduced lung function, poor mobility and symptoms of post-traumatic stress disorder (PTSD) four months after being discharged.

Read more: What is long COVID?

The medics concluded more than half (53%) endured some degree of “functional impairment” after supposedly overcoming the coronavirus.

Watch: What is long COVID?

Early research suggests the coronavirus is mild in four out five cases, while a third are said to be asymptomatic.

In severe incidents, however, the infection can trigger the disease COVID-19, resulting in life-threatening complications like pneumonia or sepsis.

Expert understanding of the coronavirus means treatments have come a long way since it was identified at the end of 2019.

“In contrast, the type and severity of respiratory or functional sequelae COVID-19 are unknown,” the medics wrote in the journal JAMA Network Open.

Read more: Teacher develops stammer after coronavirus

The coronavirus can cause cell damage and bleeding in the lungs, which may leave the organs less able to transfer oxygen to the blood, triggering “impairment in exercise capacity”.

This arose in some survivors of Severe acute respiratory syndrome (Sars) and Middle East respiratory syndrome (Mers); infections from the same class as the circulating coronavirus.

“Moreover, the functional impairment associated with COVID-19 may also be associated with adverse psychological outcomes,” wrote the medics.

Unable to marshal the right cells and molecules to fight off the invader, the bodies of the infected instead launch an entire arsenal of weapons — a misguided barrage that can wreak havoc on healthy tissues, experts said. (Getty Images)
The coronavirus may cause cell damage and bleeding in the lungs. (Stock, Getty Images)

To learn more, the Piedmont medics analysed 219 adults with confirmed coronavirus “severe enough to require hospital admission”.

The results reveal 113 (51%) of the patients had a “diffusing lung capacity for carbon monoxide (DLCO) less than 80% of expected value”.

DLCO describes the ability of the lungs to transfer gases from inhaled air into the bloodstream, acting as an indicator of damage to the organs.

This was less than 60% in 34 (15%) of the patients.

Reduced lung capacity was more common among the female participants, “possibly reflecting fitness level”, as well as those with chronic obstructive pulmonary disease and who were admitted to intensive care.

Read more: Hospice nurse ‘hit like a brick wall’ during pandemic

Mobility was measured via the short physical performance battery test, which looks at balance and walking speed. A score under 10 indicates “mobility limitations” and is a predictor of “all-cause mortality”.

Just over one in five (22%) of the patients had a score of less than 11.

The two-minute walk test – the distance an individual can move in this time – was “outside reference ranges of expected performance of age and sex” for two in five (40%) of the patients.

This may be due to lung damage, poor circulation, muscle weakness or nerve dysfunction. Admission to intensive care can also cause “de-conditioning”.

“Remarkably”, age was not associated with reduced lung function or poor mobility.

“We speculate older people may have a higher baseline comorbidity burden, which was detrimentally associated with their survival probability during acute illness, but in survivors, the residual damage was not worse than in younger people,” wrote the scientists.

“Essentially, this finding confirms older individuals who survive COVID-19 may not be less able than their younger counterparts to revert to their previous state of health, with no accrual of morbidity.”

Symptoms of post-traumatic stress were seen in almost one in five (17%) of the patients, particularly the men. These may include flashbacks, nightmares or feeling on edge.

The scientists also found shortness of breath persisted in around one in 10 (10%) of the patients who experienced it while seriously ill with the coronavirus.

Nearly one in five (17%) also endured alterations to their taste and smell four months on. “How long this loss will persist is unknown,” wrote the scientists.

The results further reveal a third of the patients who experienced joint and muscle pain while infected with the coronavirus still had these symptoms at the time of the Piedmont study.

In a more serious development, around 5% of the participants died within a few weeks of being discharged.

“Although we have no information on the causes of death for these patients, this proportion is not negligible and represents, to our knowledge, a worrying novelty,” wrote the scientists.

They concluded: “A significant proportion of patients hospitalised for COVID-19 still reported a high proportion of symptoms associated with COVID-19 up to four months after hospital discharge, with reduced exercise tolerance being the most common.

“Other midterm sequelae of COVID-19, such as respiratory and physical functional impairment, may impact psychological health.

“Residual lung injury may be associated with reduced quality of life in survivors of COVID-19.”

Watch: Can you catch coronavirus twice?