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The majority of survivors who left hospital following COVID-19 did not fully recover five months after discharge and continued to experience negative impacts on their physical and mental health, as well as ability to work, according to results released by the PHOSP-COVID study.

PHOSP-COVID logo, with the slogan "Improving long-term health outcomes' written underneath.

The PHOSP-COVID study, which involves a number of Oxford researchers across a range of disciplines, also found that one in five of the participant population reached the threshold for a new disability.

These initial findings of the study, which is supported by the NIHR Oxford Biomedical Research Centre (BRC) and the NIHR Oxford Health BRC, were published on the medRxiv pre-print server.

The UK-wide study, which is led by the NIHR Leicester BRC, analysed 1,077 patients who were discharged from hospital between March and November 2020 following an episode of COVID-19.

Researchers found that each participant had an average of nine persistent symptoms. The ten most common symptoms reported were:

  • Muscle pain
  • Fatigue
  • Physical slowing down
  • Impaired sleep quality
  • Joint pain or swelling
  • Limb weakness
  • Breathlessness
  • Pain
  • Short-term memory loss
  • Slowed thinking

Patients were also assessed for mental health. The study reports that over 25 per cent of participants had clinically significant symptoms of anxiety and depression and 12 per cent had symptoms of post-traumatic stress disorder (PTSD) at their five-month follow-up.

Professor John Geddes, Head of the Department of Psychiatry and Director of the NIHR Oxford Health BRC, said:

 

These first results from PHOSP-COVID begin to clarify the experience of patients who have been admitted to hospital with COVID-19. The study has been another impressively swift and collaborative national NHS effort so far and my thanks to the patients and investigators who have made it happen. PHOSP-COVID will gain on power as it proceeds and promises to provide critical insights into the mechanisms that underly the mental, cognitive and physical symptoms that make up Long COVID. That should allow us to design better treatments and tailor care to individual patient needs.

Of the 67.5 per cent of participants who were working before COVID, 17.8 per cent were no longer working, and nearly 20 per cent experienced a health-related change in their occupational status.

Those who experience more persistent symptoms tend to be middle-aged, white, female, with at least two comorbidities, such as diabetes, lung or heart disease. Cognitive impairment, also referred to as ‘brain fog’, occurs as a predominant symptom in a sub-set of patients who tend to be older and male.

A biological marker associated with inflammation, C-Reactive Protein (CRP), is elevated in all but the most mild of post-hospital cases.

The three academics leading the study in Oxford are Professor John Geddes, Head of Department of Psychiatry and Director of the NIHR Oxford Health BRC, Associate Professor Ling-Pei Ho, Respiratory Consultant and Specialist in Respiratory Immunology, and Professor Stefan Neubauer, Oxford BRC Theme Lead for Imaging.

Read the full press release from the NIHR Leicester BRC.

See information on coverage of the study.