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People hospitalised with COVID-19 are likely to face a limited recovery, finds NIHR- funded study

Lady with long COVID

People who were hospitalised with COVID-19 and continued to experience symptoms at five months show limited further recovery one year after hospital discharge, a key finding of the Post-hospitalisation COVID-19 study (PHOSP-COVID) has revealed.

The NIHR/UKRI-funded study, led by the NIHR Leicester Biomedical Research Centre, also confirmed that people who were less likely to make a full recovery from COVID-19 were female, obese, and required invasive mechanical ventilation (IMV) to support their breathing during their hospital stay.

Researchers from 53 institutions and 83 hospitals across the UK assessed 2,230 adults who had been hospitalised with COVID-19. All participants completed a five-month assessment; and so far, 807 people have completed both the five-month and 12-month assessments. Recovery was measured using patient-reported data, physical performance and organ function tests. Participant blood samples at the five-month visit were analysed for around 300 substances linked to inflammation and immunity.

The study, released as a pre-print on medRxiv today, found that one year after hospital discharge, less than three in ten patients reported they felt fully recovered, largely unchanged from at five months. The most common ongoing symptoms were fatigue, muscle pain, physically slowing down, poor sleep and breathlessness. Participants felt their health-related quality of life remained substantially worse one year after hospital discharge, compared to pre-COVID. This suggests the physical and mental health impairments reported in the study are unlikely to be pre-existing conditions.

Professor Chris Brightling, NIHR Senior Investigator and Professor of Respiratory Medicine at the University of Leicester, and Chief Investigator for the PHOSP-COVID study, said: “The PHOSP-COVID study is further evidence of the UK’s ability to combine expertise across both disease area and geography to rapidly gather data to help us understand the longer term implications of Long-COVID in hospitalised patients with persistent symptoms. Our findings show that people who were hospitalised and went on to develop Long-COVID are not getting substantially better a year after they were discharged from hospital. Many patients in our study had not fully recovered at five months and most of these reported little positive change in their health condition at one year.

“When you consider that over half a million people in the UK have been admitted to hospital as a result of COVID-19, we are talking about a sizeable population at risk of persistent ill-health and reduced quality of life.”

Professor Nick Lemoine, Chair of NIHR’s Long-COVID funding committee and Medical Director of the NIHR Clinical Research Network (CRN), said: "These results bring into sharp focus the extent to which Long-COVID affects people's long term health and quality of life. Only by funding and delivering this research, can we seek to improve health outcomes and configure healthcare services to provide the absolute best care.

“Earlier this year, the NIHR announced £50 million into research covering the full spectrum of causes, mechanisms, diagnosis, treatment and rehabilitation of Long-COVID; a demonstration of our commitment to tackle this long term condition."

The PHOSP-COVID study is available as a pre-print, which means it is yet to be checked by other scientists.