Covid 19: The long-term health effects of Covid 19 remain largely uncertain. The purpose of this study was to identify the long-term health effects. Also patients also discharged from hospital with Covid 19. To examine the related risk factors, in particular the seriousness of the disease.

Covid-19

Methods

We conducted an ambidirectional cohort analysis. Also the COVID-19 patients who are released between Jan 7, 2020, and May 29, 2020 from Jin Yin-tan Hospital (Wuhan, China). Therefore, patients who died before follow-up and patients with whom it would be impossible to follow up. Due to mental illnesses, dementia or hospital re-admission. Also Those who were enable to travel easily before or after discharge due to concomitant osteoartropathy. Immobile due to diseases such as stroke or pulmonary embolism. Also those who didn’t participate were unable to be reached. Living outside Wuhan or in nursing or welfare homes are all removed.

Determination of symptoms helped them by providing questionnaires. Complete physical examinations and a 6-min walking test, and received blood tests. During the stay a stratified sampling was used in patients. As 3, 4, and 5-6 according to their highest seven-category scale. To obtain a pulmonary function test examination, high resolution CT of the chest, and ultrasonography. Enrolled patients who participated in the SARS-CoV-2 Suppression Trial of Lopinavir in China obtained an antibody screen. It is for extreme acute respiratory syndrome, coronavirus 2. To assess the relationship between disease intensity and long-term health effects, multivariable modified linear or logistic regression models are used.

Findings

Out of 2469 released COVID-19 patients, 1733 enrolled in total after 736 are remove. The median age of patients was 57.0 years (IQR 47.0-65.0) and 897 (52 percent) were males. From June 16 to Sept 3, 2020, the follow-up analysis took place The median follow-up period after symptom initiation was 186.0 (175.0-199.0) days. The most common symptoms were exhaustion or muscle weakness. (63 percent, 1038 of 1655) and sleep problems (26 percent, 437 of 1655).

Among 23 percent (367 of 1617) of patients, anxiety or depression registered. For those at severity scale 3, 22 percent for severity scale 4, and 29 percent for severity scale 5-6. Also the proportion of median 6-min walking distance less than the lower limit of the normal range was 24 percent. For severity scale 3, 29 percent for scale 4, and 56 percent for scale 5–6. The corresponding proportions of patients with diffusion deficiency were 22 percent.

The median CT scores were 3•0 (IQR 2•0–5•0) for severity scale 3, 4•0 (3•0–5•0) for scale 4, and 5•0 (4•0–6•0) for scale 5–6. After multivariable change, patients showed a 1-61 (95 percent CI 0-80-3-25) odds ratio (OR) for scale 4 versus scale 3. The 4-60 (1-85-11-48) for scale 5-6 versus scale 3 for diffusion impairment; OR 0-88 (0-66-1-17) for scale 4 versus scale 3 and OR 1-77 (1-05-2-97) for scale 5-6 versus scale 3 for anxiety or depression; and OR 0-74 (0-58-0-96) for scale 4 versus scale 3 and 2-69 (1-46-4-969) for scale 5-6 versus scale 3 for anxiety or depression.

Also 107 of 822 participants with no acute kidney injury and an average glomerular filtration rate (eGFR) of 90 mL/min per 1-73 m2 or more in the acute period had a follow-up eGFR of less than 90 mL/min per 1-73 m2.

Interpretation

COVID-19 survivors predominantly affected by exhaustion or muscle weakness, sleep difficulties, and anxiety or depression at 6 months after acute infection. Also the patients who are more critically ill during their hospital had more extreme diminished capacity for pulmonary diffusion. As well as irregular signs of chest imaging. Also are the key long-term treatment intervention target group.

Funding

China’s National Natural Science Foundation, China’s Academy of Medical Sciences Innovation Fund for Medical Sciences, China’s National Main Research and Development Program, China’s Major National Science and Technology Projects on New Drug Production and Pulmonary Tuberculosis Development, and the Foundation of the Beijing Union Medical College.

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