Healthy outcomes of patients with COVID-19 two years after the infection: a prospective cohort study

ABSTRACT

The long-term effect of coronavirus disease 2019 (COVID-19) has been rarely known. This study aimed to investigate healthy outcomes of COVID-19 survivors up to 2 years after the infection. A total of 155 COVID-19 patients, who were discharged from Shenzhen Third People's Hospital from February 2020 to April 2020, were enrolled and followed up until March 4, 2022. COVID-19 survivors received questionnaires of long COVID symptoms and psychological symptoms, pulmonary function tests, chest computed tomography (CT) scans and routine laboratory tests. Two years after infection, 36.6% of patients had at least one symptom of long COVID. Vision impairment and fatigue were the most common symptom. 35.0% of participants still had at least one psychological symptom of anxiety, depression, post-traumatic stress symptoms, and sleep difficulties. Radiographic abnormalities were presented in 50.7% of patients, with the most common features of fibrosis-like lesions and residual ground-glass opacity. Diffuse dysfunction (24.0%) was the main abnormalities of pulmonary function tests. Most laboratory parameters returned to normal range, while persistent abnormalities in kidney and liver function test were observed in a subset of participants after discharge. Two years after COVID-19 infection, persistent symptoms of long COVID and psychological symptoms, as well as abnormalities in pulmonary function tests and CT, were still common in a subset of recovering individuals. These findings were limited by the lack of a healthy control group and pre-COVID assessments, which should be confirmed by further large-scale studies.

KEYWORDS:

• COVID-19
• SARS-CoV-2
• long COVID
• follow-up
• risk factor

Acknowledgments

We thank all patients who participated in this study and all of the staff from Shenzhen Third People’s Hospital. LL, ZZ, GL and QH designed this study; ZM, JD, GZ, and MZ collected the data; DL, XL, ZL, and FW analyzed and interpreted the data; DL and XL wrote the manuscript; LL, ZZ, GL and QH revised the manuscript. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the National Science Fund for Distinguished Young Scholars [grant number 82025022], the Central Charity Fund of Chinese Academy of Medical Science [grant number 2020-PT310-009], the Emergency Grants for Prevention and Control of SARS-CoV-2 of Guangdong Province [grant number 2022A1111090001], the Science and Technology Innovation Committee of Shenzhen Municipality [grant number JSGG20200207155251653], [grant number JSGG20220226090002003], [grant number JCYJ20190809160213289], and the Emergency Key Program of Guangzhou Laboratory [grant number EKPG21-29].