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RETRACTED: 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study
Open accessAbstract
Background The long-term health consequences of COVID-19 remain largely unclear. The aim of this study was to describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity.Methods We did an ambidirectional cohort study of patients with confirmed COVID-19 who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7, 2020, and May 29, 2020. Patients who died before follow-up, patients for whom follow-up would be difficult because of psychotic disorders, dementia, or re-admission to hospital, those who were unable to move freely due to concomitant osteoarthropathy or immobile before or after discharge due to diseases such as stroke or pulmonary embolism, those who declined to participate, those who could not be contacted, and those living outside of Wuhan or in nursing or welfare homes were all excluded. All patients were interviewed with a series of questionnaires for evaluation of symptoms and health-related quality of life, underwent physical examinations and a 6-min walking test, and received blood tests. A stratified sampling procedure was used to sample patients according to their highest seven-category scale during their hospital stay as 3, 4, and 5-6, to receive pulmonary function test, high resolution CT of the chest, and ultrasonography. Enrolled patients who had participated in the Lopinavir Trial for Suppression of SARS-CoV-2 in China received severe acute respiratory syndrome coronavirus 2 antibody tests. Multivariable adjusted linear or logistic regression models were used to evaluate the association between disease severity and long-term health consequences.Findings In total, 1733 of 2469 discharged patients with COVID-19 were enrolled after 736 were excluded. Patients had a median age of 57·0 (IQR 47·0-65·0) years and 897 (52%) were men. The follow-up study was done from June 16, to Sept 3, 2020, and the median follow-up time after symptom onset was 186·0 (175·0-199·0) days. Fatigue or muscle weakness (63%, 1038 of 1655) and sleep difficulties (26%, 437 of 1655) were the most common symptoms. Anxiety or depression was reported among 23% (367 of 1617) of patients. The proportions of median 6-min walking distance less than the lower limit of the normal range were 24% for those at severity scale 3, 22% for severity scale 4, and 29% for severity scale 5-6. The corresponding proportions of patients with diffusion impairment were 22% for severity scale 3, 29% for scale 4, and 56% for scale 5-6, and median CT scores were 3·0 (IQR 2·0-5·0) for severity scale 3, 4·0 (3·0-5·0) for scale 4, and 5·0 (4·0-6·0) for scale 5-6. After multivariable adjustment, patients showed an odds ratio (OR) 1·61 (95% CI 0·80-3·25) for scale 4 versus scale 3 and 4·60 (1·85-11·48) for scale 5-6 versus scale 3 for diffusion impairment; OR 0·88 (0·66-1·17) for scale 4 versus scale 3 and OR 1·77 (1·05-2·97) for scale 5-6 versus scale 3 for anxiety or depression, and OR 0·74 (0·58-0·96) for scale 4 versus scale 3 and 2·69 (1·46-4·96) for scale 5-6 versus scale 3 for fatigue or muscle weakness. Of 94 patients with blood antibodies tested at follow-up, the seropositivity (96·2% vs 58·5%) and median titres (19·0 vs 10·0) of the neutralising antibodies were significantly lower compared with at the acute phase. 107 of 822 participants without acute kidney injury and with estimated glomerular filtration rate (eGFR) 90 mL/min per 1·73 m 2 or more at acute phase had eGFR less than 90 mL/min per 1·73 m 2 at follow-up.Interpretation At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery.Funding National Natural Science Foundation of China, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, and Peking Union Medical College Foundation.
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“Nevertheless, what emerges from preliminary data is the negative impact of long COVID on quality of life and its effects on patient work ability and social relationships [1,4,19].”
From Female gender is associated with long COVID syndrome: a prospective cohort study (2022) · cites this paper as [1]
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“These mental health symptoms persist even after the acute stage of the disease.”
From Psychological treatments for the mental health symptoms among individuals infected with COVID-19: a scoping review protocol (2023) · cites this paper as [5]
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“Further, severe lung complications from COVID-19 may have persisting limitations to respiratory function and gas exchange; this group of patients, therefore, should be the primary target population for the intervention of long-term recovery.”
From Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study (2022) · cites this paper as [32]
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“Abdominal chest imaging, and severe impairment to pulmonary diffusion capacities was reported in COVID-19 patients recovered from severe illness [32].”
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“These symptoms can endure up to 6–7 months and even longer [[1], [2], [3], [4], [5]].”
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“Advanced age was associated with ongoing fatigue and musculoskeletal pain, or impairment in pulmonary functions, reflecting a decline in organ function and a slower ability to recover [1,16].”
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“Literature data are not equivocal about the association between females and long COVID: some preliminary studies have shown an increased prevalence of fatigue [24] or other symptoms among women [1,5,13,16], while in other studies no gender association was found [4,[18], [19], [20]].”
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Nehme, M., Braillard, O., Chappuis, F., CoviCare Study Team, Nehme, M., Braillard, O., Vetter, P., Courvoisier, D. S., Assal, F., Lador, F., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-18673-z · Cited by 53
The Impact of the COVID-19 Pandemic on Dementia Risk: Potential Pathways to Cognitive Decline
Pyne, J. D., & Brickman, A. M. (2021) · Neurodegenerative Diseases · doi:10.1159/000518581 · Cited by 50
Iwashyna, T. J., Kamphuis, L. A., Gundel, S. J., Hope, A. A., Jolley, S. E., Admon, A. J., Caldwell, E., Monahan, M. L., Hauschildt, K. E., Thompson, B., et al. (2021) · Journal of Hospital Medicine · doi:10.12788/jhm.3660 · Cited by 48
Maley, J. H., Alba, G. A., Barry, J. T., Bartels, M. N., Fleming, T. K., Oleson, C. V., Rydberg, L., Sampsel, S., Silver, J. K., Sipes, S., et al. (2021) · PM&R · doi:10.1002/pmrj.12744 · Cited by 49
Return to work after COVID-19 infection – A Danish nationwide registry study
Jacobsen, P. A., Andersen, M. P., Gislason, G., Phelps, M. D., Butt, J. H., Køber, L., Schou, M., Fosbøl, E. L., Christensen, H. C., Torp-Pedersen, C., et al. (2022) · Public Health · doi:10.1016/j.puhe.2021.12.012 · Cited by 48
Health-related quality of life of COVID-19 two and 12 months after intensive care unit admission
Demoule, A., Morawiec, É., Decavèle, M., Ohayon, R., Malrin, R., Galarza-Jimenez, M.-A., Laveneziana, P., Morélot‐Panzini, C., Similowski, T., Rycke, Y. D., et al. (2022) · Annals of Intensive Care · doi:10.1186/s13613-022-00991-0 · Cited by 48
T‐cell recovery and evidence of persistent immune activation 12 months after severe COVID ‐19
Taeschler, P., Adamo, S., Deng, Y., Cervia, C., Zurbuchen, Y., Chevrier, S., Raeber, M. E., Hasler, S., Bächli, E., Rudiger, A., et al. (2022) · Allergy · doi:10.1111/all.15372 · Cited by 51
Coenzyme Q10 + alpha lipoic acid for chronic COVID syndrome
Barletta, M. A., Marino, G., Spagnolo, B., Bianchi, F. P., Falappone, P. C. F., Spagnolo, L., & Gatti, P. (2022) · Clinical and Experimental Medicine · doi:10.1007/s10238-022-00871-8 · Cited by 49
Patel, M. S., Milkman, K. L., Gandhi, L., Graci, H. N., Gromet, D. M., Ho, H., Kay, J., Lee, T. W., Rothschild, J., Akinola, M., et al. (2022) · American Journal of Health Promotion · doi:10.1177/08901171221131021 · Cited by 48
Nehme, M., Vetter, P., Chappuis, F., Kaiser, L., Guessous, I., for the CoviCare Study Team, Nehme, M., Vetter, P., Braillard, O., Assal, F., et al. (2022) · Clinical Infectious Diseases · doi:10.1093/cid/ciac947 · Cited by 49
Hausswirth, C., Schmit, C., Rougier, Y., & Coste, A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20021361 · Cited by 52
Functional neurological disorder in people with long COVID : A systematic review
Teodoro, T., Chen, J., Gelauff, J., & Edwards, M. J. (2023) · European Journal of Neurology · doi:10.1111/ene.15721 · Cited by 48
Ballout, R. A., Kong, H., Sampson, M. L., Otvos, J. D., Cox, A. L., Agbor-Enoh, S. T., & Remaley, A. T. (2021) · Biomedicines · doi:10.3390/biomedicines9091090 · Cited by 49
Utrero‐Rico, A., González‐Cuadrado, C., Chivite‐Lacaba, M., Cabrera-Marante, Ó., Laguna‐Goya, R., Almendro-Vázquez, P., Díaz‐Pedroche, C., Ruiz‐Ruigómez, M., Lalueza, A., Folgueira, M. D., et al. (2021) · Biomedicines · doi:10.3390/biomedicines9091253 · Cited by 48
Depressive and Neurocognitive Disorders in the Context of the Inflammatory Background of COVID-19
Dąbrowska, E., Galińska-Skok, B., & Waszkiewicz, N. (2021) · Life · doi:10.3390/life11101056 · Cited by 47
Rao, S., Benzouak, T., Gunpat, S., Burns, R. J., Tahir, T. A., Jolles, S. R. A., & Kisely, S. R. (2021) · Annals of Behavioral Medicine · doi:10.1093/abm/kaab081 · Cited by 51
Staudt, A., Jörres, R. A., Hinterberger, T., Lehnen, N., Loew, T. H., & Budweiser, S. (2021) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2021.10.031 · Cited by 49
Li, T., Su, Y., Chen, F., Liao, X., Wu, Q. J., Kang, Y., Tan, Y., & Zhou, Z. (2021) · Advanced Intelligent Systems · doi:10.1002/aisy.202100193 · Cited by 47
Acute and post-acute COVID-19 presentations in athletes: a systematic review and meta-analysis
Lemes, Í. R., Smaira, F. I., Ribeiro, W. J. D., Favero, N. K., de Matos, L. D. N. J., Pinto, A. L. D. S., Dolan, E., & Gualano, B. (2022) · British Journal of Sports Medicine · doi:10.1136/bjsports-2022-105583 · Cited by 47
What SARS-CoV-2 does to our brains
Aschman, T., Mothes, R., Heppner, F. L., & Radbruch, H. (2022) · Immunity · doi:10.1016/j.immuni.2022.06.013 · Cited by 50
Nielsen, T. B., Leth, S., Pedersen, M., Harbo, H. D., Nielsen, C. V., Laursen, C. H., Schiøttz‐Christensen, B., & Oestergaard, L. G. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192214739 · Cited by 47
Wang, M., Zhang, Y., Li, C., Chang, W., & Zhang, L. (2023) · Frontiers in Immunology · doi:10.3389/fimmu.2023.1180336 · Cited by 48
Self-citationChronic Lung Injury after COVID-19 Pneumonia: Clinical, Radiologic, and Histopathologic Perspectives
Cha, M. J., Solomon, J. J., Lee, J. E., Choi, H., Chae, K. J., Lee, K. S., & Lynch, D. A. (2024) · Radiology · doi:10.1148/radiol.231643 · Cited by 47
Persistence of symptoms after improvement of acute COVID19 infection, a longitudinal study
Abdelrahman, M. M., Abd‐Elrahman, N. M., & Bakheet, T. M. (2021) · Journal of Medical Virology · doi:10.1002/jmv.27156 · Cited by 51
Long-term impact of COVID-19 associated acute respiratory distress syndrome
Aranda, J., Oriol, I., Martín, M. C., Feria, L., Vázquez, N., Rhyman, N., Vall-Llosera, E., Pallarés, N., Coloma, A., Pestaña, M., et al. (2021) · Journal of Infection · doi:10.1016/j.jinf.2021.08.018 · Cited by 47
Albu, S., Zozaya, N. R., Murillo, N., García‐Molina, A., Chacón, C. A. F., & Kumru, H. (2021) · Disability and Rehabilitation · doi:10.1080/09638288.2021.1977398 · Cited by 47
Pain Burden in Post-COVID-19 Syndrome following Mild COVID-19 Infection
Bilevičiūtė-Ljungar, I., Norrefalk, J., & Borg, K. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11030771 · Cited by 51
Sleep and Circadian Health of Critical COVID-19 Survivors 3 Months After Hospital Discharge
Benitez, I. D., Moncusí‐Moix, A., Vaca, R., Gort‐Paniello, C., Mínguez, O., Santisteve, S., Carmona, P., Torres, G., Fagotti, J., Gonzalo Labarca, T., et al. (2022) · Critical Care Medicine · doi:10.1097/ccm.0000000000005476 · Cited by 48
Kim, Y., Kim, S., Chang, H., Kwon, K. T., Bae, S., & Hwang, S. (2021) · Infection and Chemotherapy · doi:10.3947/ic.2021.0022 · Cited by 47
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Mirfazeli, F. S., Sarabi‐Jamab, A., Pereira-Sánchez, V., Kordi, A., Shariati, B., Shariat, S. V., Bahrami, S., Nohesara, S., Almasi‐Dooghaee, M., & Faiz, S. H. R. (2022) · Neurological Sciences · doi:10.1007/s10072-021-05786-y · Cited by 48
Pappa, S., Barmparessou, Z., Athanasiou, N., Sakka, E., Eleftheriou, K., Patrinos, S., Sakkas, N., Pappas, A., Kalomenidis, I., & Katsaounou, P. A. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12030486 · Cited by 49
A point-of-care lateral flow assay for neutralising antibodies against SARS-CoV-2
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The Robustness of Cellular Immunity Determines the Fate of SARS-CoV-2 Infection
Moga, E., Lynton‐Pons, E., & Domingo, P. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.904686 · Cited by 48
"I feel like my body is broken": exploring the experiences of people living with long COVID
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Self-citationSíndrome de COVID-19 persistente. Una revisión narrativa
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Metadata
- Authors
- Huang, C., Huang, L., Wang, Y., Li, X., Ren, L., Gu, X., Kang, L., Guo, L., Liu, M., Zhou, X., Luo, J., Huang, Z., Tu, S., Zhao, Y., Chen, L., Xu, D., Li, Y., Li, C., Peng, L., Li, Y., Xie, W., Cui, D., Shang, L., Fan, G., Xu, J., Wang, G., Wang, Y., Zhong, J., Wang, C., Wang, J., Zhang, D., & Cao, B.
- Affiliations
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Capital Medical University (CN)
- China-Japan Friendship Hospital (CN)
- Jinyintan Hospital (CN)
- Peking University (CN)
- Harbin Medical University (CN)
- Beijing University of Chinese Medicine (CN)
- Tsinghua University (CN)
- Corresponding author
- Cao, Bin
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 397
- Issue
- 10270
- Pages
- 220-232
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC7833295
- OpenAlex
- W3120387768
- Cited by
- 4,084
- References
- 41
- Citations by year
- 2026: 67 · 2025: 180 · 2024: 510 · 2023: 934 · 2022: 1300 · 2021: 1088
- FWCI
- 458.37
- Type
- journal article
- Language
- en
- Status
- Retracted
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science and Technology Major Project (2020ZX09201001)
- Chinese Academy of Medical Sciences (2020-I2M-CoV19\u2013005)
- National Natural Science Foundation of China (82041011/H0104)
- National Key Research and Development Program of China (2018YFC1200102)
- China-Japan Friendship Hospital
- Topics
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- COVID-19 pandemic, long-term health effects, long COVID, fatigue, muscle weakness, sleep disorders, anxiety, depression, disease severity, health-related quality of life, physical function, lung function, SARS-CoV-2, retraction, Wuhan, post-discharge follow-up, risk factors, lopinavir
- MeSH terms
- COVID-19, SARS-CoV-2, COVID-19 Serological Testing, Post-Acute COVID-19 Syndrome, Aged, China, Fatigue, Female, Humans, Length of Stay, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Sleep Wake Disorders, Cohort Studies, Comorbidity, Muscle Weakness, Pandemics
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