COVID-19 symptoms remained for at least 6 months for some Wuhan patients, study finds

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WUHAN, China - Researchers have found that some of the first people to be hospitalized for COVID-19 experienced symptoms lasting for up to six months.

According to a study published this month in the medical journal The Lancet, researchers looked at 1,722 coronavirus patients who had been discharged from Jin Yin-tan hospital in Wuhan, China, where the disease was first identified.

The patients were discharged from the hospital between January 7, 2020, and May 29, 2020, and were then interviewed about their symptoms and quality of life pertaining to their health. They were also administered physical examinations and blood tests, as well as a six-minute walking test.

Approximately three-quarters of the patients still reported symptoms within six months after contracting the deadly virus.

More than 60% reported still experiencing fatigue or muscle weakness, while 23% reported anxiety and depression.

"At six months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression," study authors write. "Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery."

Outside of the study, many others have reported long-term symptoms as well. Since the first reported cases of COVID-19, several support groups have emerged on Facebook consisting of thousands of members calling themselves "long haul survivors."

"Today is day 93," said Amy Watson, a preschool teacher who lives in Portland, Oregon as she shared a photograph of her thermometer that read 100.3 on June 18, 2020. She first tested positive for COVID-19 on April 11, 2020 after falling ill with flu-like symptoms in mid-March.

On Sept. 15., Watson posted an update of her condition on Facebook writing "Six months. 185 days. I still have a fever."

"I also have a diagnosis: post-viral dysautonomia. My autonomic nervous system (ANS) was damaged by COVID-19. This controls things like breathing, heart function, digestion, perspiration, temperature regulation, and vision. I have brain damage," Watson wrote including a flurry of other long term and devastating symptoms.

She and many other "long haul survivors" are confused and frustrated, and have said many medical workers who have treated them have been left with their hands in the air after their symptoms did not seem to subside.

The U.S. Centers for Disease Control and Prevention acknowledged these long term effects saying "While most persons with COVID-19 recover and return to normal health, some patients can have symptoms that can last for weeks or even months after recovery from acute illness."

According to the CDC, the most commonly reported long-term symptoms include:

Fatigue
Shortness of breath
Cough
Joint pain
Chest pain

But the health agency says other reported long-term symptoms include:

Difficulty with thinking and concentration (sometimes referred to as "brain fog")
Depression
Muscle pain
Headache
Intermittent fever
Fast-beating or pounding heart (also known as heart palpitations)

But the CDC’s list still doesn’t cover certain byproducts of the coronavirus identified by other researchers.

According to a study from the National Institutes of Health, researchers found evidence to suggest that brain damage may be a product of COVID-19. Researchers uncovered blood vessel damage and inflammation in the brains of 19 deceased COVID-19 patients.

"We found that the brains of patients who contract infection from SARS-CoV-2 may be susceptible to microvascular blood vessel damage. Our results suggest that this may be caused by the body’s inflammatory response to the virus" said Avindra Nath, M.D., clinical director at the NIH’s National Institute of Neurological Disorders and Stroke (NINDS).

Nath, the senior author of the study added that while COVID-19 is most commonly known to be a respiratory illness, he hopes this study will help the medical community recognize the scope of complications that can arise out of contracting the deadly coronavirus.

"We hope these results will help doctors understand the full spectrum of problems patients may suffer so that we can come up with better treatments," Nath said.

Previous studies have indicated that people infected with COVID-19 may suffer other neurological effects. In a separate October study of more than 84,000 people, led by Adam Hampshire, a doctor at Imperial College London, researchers found in some of the worst cases, patients experienced mental decline equivalent to the brain aging by 10 years.

When analyzing data from the patients, study authors said they found significant cognitive decline in some individuals. "[Cognitive deficits] were of substantial effect size for people who had been hospitalized, but also for mild but biologically confirmed cases who reported no breathing difficulty," the researchers wrote in a post published on MedRxiv. "Finer grained analyses of performance support the hypothesis that COVID-19 has a multi-system impact on human cognition."

Besides neurological issues, other complications including heart failure have been identified.

In a study published in September, researchers from Ohio State University found that out of more than two dozen athletes from the university who tested positive for COVID-19, 30% had cellular heart damage and 15% showed signs of heart inflammation caused by a condition known as myocarditis.

According to the Mayo Clinic, myocarditis is typically caused by a viral infection with symptoms ranging from chest pain, fatigue, shortness of breath, to a negative impact on heart rate and rhythm as seen in conditions such as arrhythmias.

The U.S. Centers for Disease Control and Prevention tweeted on Sept. 17, "Heart conditions like myocarditis are associated with some cases of #COVID19. Severe cardiac damage is rare but has occurred, even in young, healthy people."

Like so much else in the pandemic, the scientific picture of so-called long-haulers is still developing. It’s not clear how prevalent long-term COVID problems are or why some patients keep suffering while others do not.

Current indications are that up to 30% of patients continue to have significant problems that intrude on daily life two to three weeks after testing positive. Perhaps as many as 10% are still afflicted three to six months later, according to Dr. Wesley Self, a Vanderbilt University emergency physician and researcher who co-wrote a July report from the CDC.

Long-term COVID-19 care has been launched in settings ranging from big research hospitals like New York’s Mount Sinai, which has over 1,600 patients, to St. John’s Well Child and Family Center, a network of community clinics in south Los Angeles.

There’s no proven cure for long-term COVID problems. But clinics aim to offer relief, not least by giving patients somewhere to turn if their usual doctor can’t help.

"We wanted to create a place that patients could get answers or feel heard," even if there are still unanswered questions, said Dr. Denyse Lutchmansingh, the clinical lead physician at Yale Medicine’s Post-COVID Recovery Program.

At the Jamaica Hospital Medical Center, in New York, a clinic specifically for post-COVID-19 care, patients get mental health assessments, a lung specialist’s attention and physical exams that delve deeper than most into their lifestyles, personal circumstances and sources of stress. Several hundred people have been treated so far, according to Dr. Alan Roth, who oversees the clinic.

The idea is to help patients "build their own healing capacity," said Dr. Wayne Jonas, former director of the National Institutes of Health’s Office of Alternative Medicine. He is now with the Samueli Foundation, a California-based nonprofit that works with the hospital on marrying alternative ideas with conventional medicine.

The long-haulers get exercise and diet plans and group or individual mental health sessions. Recommendations for supplements, breathing exercises and meditation are also likely. That’s in addition to any prescriptions, referrals or primary care follow-ups that are deemed necessary.

"We’re not just saying, ‘It’s all in your head, and we’re going to throw herbs and spices at you,’" Roth said. With no tidy, proven answer for the complex of symptoms, "we do a common-sense approach and take the best of what’s out there to treat these people."

The Associated Press contributed to this story.