Since the beginning of the COVID-19 pandemic, the immediate and sometimes lethal danger posed by the virus has been widely reported and studied. But fairly early on, it was also clear that while some people seem to recover from the infection without any ongoing health problems, others have health issues that linger even when they’ve mostly recovered — and why this happens in some people, but not others, isn’t often clear.
Right now, there is strong evidence showing that certain health conditions — including diabetes — increase the risk of poor outcomes in people who develop COVID-19, such as the need for hospitalization, admission to the intensive care unit (ICU) and death. But there isn’t much useful data on factors that influence long-term symptoms associated with COVID-19.
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While our understanding of long-term health problems from COVID-19 is still a bit fuzzy, a new study from the original epicenter of the pandemic in Wuhan, China, may help make that picture a bit clearer.
Fatigue, mental health problems common months after infection
The study, published in the journal The Lancet, looked at COVID-19 patients discharged from a hospital in Wuhan between January 7 and May 29, 2020. Researchers followed up with them six months later, and excluded from the study anyone for whom follow-up would be complicated or impossible — due to death, dementia, hospital readmission, severe disability due to stroke or living in another region. The remaining 1,733 eligible study participants were given a series of questionnaires about their symptoms and quality of life, and underwent a physical exam, blood tests, and a six-minute walking test.
Six months after their hospital discharge, study participants reported a range of ongoing health issues. The most common were fatigue or muscle weakness, affecting 76%, and sleep difficulties, affecting 26%. Next most common was anxiety or depression, which affected 23% of participants.
There were also some notable findings from the tests participants were given. Many participants scored below the normal range of their walking test, with only a weak correlation between illness severity and compromised walking ability. With illness severity in the hospital rated on a scale of 1 to 7, 24% of those who reached level 3 had compromised walking ability six months later. This proportion was 22% for those who reached level 4, and 29% for those who reached level 5 or 6.
The likelihood of experiencing ongoing anxiety or depression, or fatigue or muscle weakness, also didn’t neatly line up with illness severity. Compared with those who reached severity level 3 in the hospital, those who reached level 4 were 12% less likely to experience anxiety or depression, while those who reached level 5 or 6 were 77% more likely to experience these problems. For fatigue or muscle weakness, compared with level 3, those who reached level 4 were 26% less likely to experience these problems, while those who reached level 5 or 6 were 169% more likely to experience them.
Another health concern the researchers detected through blood tests was compromised kidney function. Out of 822 participants who didn’t experience acute kidney injury during their hospital stay and had an estimated glomerular filtration rate (eGFR) of at least 90 at that time, 107 had an eGFR below 90 at the time of follow-up six months later.
Need for more research on long-term complications
As time passes and more studies are conducted, researchers around the world hope to gain a better understanding of the lingering health issues that COVID-19 survivors experience — including what factors may help predict certain health problems. For example, it would be helpful to know if people with diabetes were more likely to experience reduced kidney function months or even years after developing COVID-19 — something the current study didn’t examine.
With a better understanding of what problems persist in COVID-19 survivors and who is most likely to experience them, doctors could screen certain people for specific problems — like anxiety or depression, or kidney or breathing problems — based on factors like chronic health conditions (including diabetes), COVID-19 severity, age or any other factor that turned out to be relevant.