Only about one in four people infected with Covid-19 feels fully recovered after a year, with women, the obese and patients who had mechanical ventilation more likely to suffer “long Covid” symptoms, according to a British study. The results are based on assessment of some 2,320 adults discharged from hospitals in Britain between March 7, 2020, and April 18, 2021. They were assessed five months after leaving hospital and 807 of them were also assessed one year after being discharged. The results were published in The Lancet Respiratory Medicine on Saturday and the study is continuing. The research was led by Christopher Brightling, Rachael Evans and Louise Wain at the University of Leicester, and funded by UK Research and Innovation and the National Institute for Health Research. It aimed to “identify factors associated with patient-perceived recovery, and identify potential therapeutic targets”. Based on patient-reported outcome measures, physical performance and organ function, the study found only 26 per cent of respondents reported they had fully recovered five months after leaving hospital. After one year, the percentage was only slightly higher at 29 per cent. “The limited recovery from five months to one year after hospitalisation in our study across symptoms, mental health, exercise capacity, organ impairment and quality of life is striking,” Evans wrote in the paper. Many patients are still suffering from long-Covid symptoms – post-infection conditions that appear mostly between weeks and months after diagnosis and can last between two months and more than a year. Among the symptoms are fatigue, shortness of breath and cognitive dysfunction or “brain fog”, defined by the World Health Organization as having trouble with attention, concentration, recall or memory. More serious symptoms – such as damage to organs, including the kidneys, lungs, pancreas and heart – raised the risk of death. The research team identified four groups or “clusters” of symptom severity. They also took the participants’ blood samples at the five-month visit to assess the presence of inflammatory proteins. Post Covid syndrome affects millions. There’s little known about its cause The team found that 20 per cent of the patients surveyed had “very severe” physical and mental health impairment, 30 per cent fell into the “severe” group, 11 per cent belonged to the “moderate” cluster, and 39 per cent had mild symptoms. Being obese, having reduced exercise capacity, a greater number of symptoms and higher levels of the inflammatory biomarker C-reactive protein were associated with the more severe clusters, the paper said. The study found women were 32 per cent less likely than men to feel fully recovered at the one-year mark, obese people were half as likely and those who received invasive mechanical ventilation in hospital were 58 per cent less likely to feel fully recovered after 12 months. “In our clusters, female sex and obesity were also associated with more severe ongoing health impairments, including reduced exercise performance and health-related quality of life at one year, potentially highlighting a group that might need higher intensity interventions such as supervised rehabilitation,” Evans said. But there were still no effective pharmacological or non-pharmacological interventions available for patients with long-Covid symptoms, the paper noted. The team said there was an urgent need for effective treatments for both physical and mental impairment. They called for specific therapeutic approaches to manage post-traumatic stress disorder. “Without effective treatments, long Covid could become a highly prevalent new long-term condition,” Brightling said. “Our study also provides a rationale for investigating treatments for long Covid with a precision-medicine approach to target treatments to the individual patient’s profile to restore their health-related quality of life.” Coronavirus persisting in faeces offers clues to cause of long Covid The team acknowledged that the study was done before the highly transmissible Omicron variant appeared, and included patients who would not have been vaccinated before contracting Covid-19. “Although our data are relevant to patients discharged under similar conditions, further research is needed to understand the effect of current acute care, newer Sars-CoV-2 variants, and vaccination status before and after contracting Covid-19,” the paper said.