People who were hospitalised with COVID-19 and still experienced symptoms at five months show limited further recovery one year after hospital discharge. This is according to the latest results of the PHOSP-COVID study, now released as a pre-print.

The study involved patients from Guy’s and St Thomas’. It was led by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre. It was jointly funded by the NIHR and MRC-UK Research and Innovation (UKRI).

The results confirm earlier research about who was less likely to make a full recovery from COVID-19. Risk factors included being female, obese and requiring ventilation during a hospital stay.

Researchers from 83 UK hospitals including those at Guy’s and St Thomas’ assessed 2,230 adults who had been hospitalised with COVID-19. All participants completed a five-month assessment. So far, 807 people have completed both the five-month and 12-month assessments.

Recovery was measured using patients’ reports, physical performance and organ function tests. Blood samples from participants at the five-month visit were also analysed.

The team found that one year after hospital discharge, less than 3 in 10 participants felt fully recovered. At five months 2.5 in 10 felt fully recovered.

The most common continued symptoms were:

  • Fatigue
  • muscle pain
  • physically slowing down
  • poor sleep

Participants felt their health-related quality of life was worse one year after hospital discharge, compared to pre-COVID. This suggests the physical and mental health impacts are unlikely to be due to pre-existing conditions.

Researchers identified four groups based on patients’ severity of impairments at five months. These ranged from ‘very severe’ group to ‘mild’. In all of these groups, there was little improvement in physical and mental health from the five-month to one-year assessments.

Professor Chris Brightling, NIHR Senior Investigator and Professor of Respiratory Medicine at the University of Leicester, was Chief Investigator for the PHOSP-COVID study. He 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.”

Dr Rachael Evans, an Associate Professor at the University of Leicester, Respiratory Consultant at Leicester’s Hospitals, was a lead author of the paper. She said: “The findings that many patients had not fully recovered one year after leaving hospital indicate that healthcare professionals will need to proactively continue assessing their patients for some time to come in order to identify their ongoing healthcare needs and provide support.

“However, we urgently need healthcare packages and medicines that target the potentially treatable traits of Long-COVID to help people feel better and get back to their normal lives. Without these, Long-COVID has the potential to become highly prevalent as a new long-term condition.”

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.

“NIHR has awarded more than £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 consortium acknowledges that there may be bias in the patients returning for one-year visits. However, the data suggests no clear differences between the patients attending the one-year follow-up and the participants in the wider study.

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

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