Long Covid: 3 groups of people at highest risk of long-term coronavirus symptoms months after infection

Only one in four patients hospitalised with Covid say they are fully recovered a year later, a new study has found.

The research, published in The Lancet Respiratory Medicine, assessed more than 2,000 patients after hospitalisation to determine the impact of long Covid.

Patients from 39 NHS hospitals agreed to five month and one year follow-up assessments in addition to their clinical care, and it was found that certain groups of people have an increased likelihood of suffering from long-term symptoms.

Who is most at risk of long Covid?

The study found that the following three groups of people had an increased likelihood of experiencing long Covid symptoms:

• Women
• The obese
• Those who were put on mechanical ventilation in hospital

Researchers said women were 32% less likely to be fully recovered from Covid 12 months after infection, while those who are obese were 50% less likely.

Patients who had mechanical ventilation in hospital were found to be the most at risk of suffering long-term symptoms, with researchers saying these people are 58% less likely to have recovered one year later.

Dr Rachael Evans, from the University of Leicester, said: "The limited recovery from five months to a year after hospitalisation in our study across symptoms, mental health, exercise capacity, organ impairment, and quality-of-life is striking.

“We found female sex and obesity were major risk factors for not recovering at one year.

"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.”

What long Covid symptoms are most common?

The most common ongoing long Covid symptoms identified by researchers were:

• fatigue
• muscle pain
• physically slowing down
• poor sleep
• breathlessness

A person who suffers ongoing symptoms for longer than 12 weeks, and the effects cannot be explained by any other condition, is said to have long Covid. The effects can be very wide-ranging and will vary from person to person.

Other common symptoms can include chest pain or tightness, problems with memory and concentration, heart palpitations, dizziness, depression and anxiety, feeling sick, diarrhoea, stomach aches and loss of appetite.

Researchers have warned that long Covid is becoming a "highly prevalent new long-term condition" and effective treatments are needed urgently to alleviate symptoms.

Professor Louise Wain, the British Lung Foundation Chair in Respiratory Research, said: "No specific therapeutics exist for long Covid and our data highlight that effective interventions are urgently required.

"Our findings of persistent systemic inflammation, particularly in those in the very severe and moderate with cognitive impairment clusters, suggest that these groups might respond to anti-inflammatory strategies.

"The concordance of the severity of physical and mental health impairment in long Covid highlights the need not only for close integration between physical and mental health care for patients with long Covid, including assessment and interventions, but also for knowledge transfer between health-care professionals to improve patient care.

"The finding also suggests the need for complex interventions that target both physical and mental health impairments to alleviate symptoms. However, specific therapeutic approaches to manage post-traumatic stress disorder might also be needed.”

Professor Christopher Brightling, National Institute for Health Research Senior Investigator, added: "Our study highlights an urgent need for health-care services to support this large and rapidly increasing patient population in whom a substantial burden of symptoms exist, including reduced exercise capacity and substantially decreased health-related quality of life one year after hospital discharge.

"Without effective treatments, long Covid could become a highly prevalent new long-term condition.

"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.”

The findings are due to be presented at the European Congress of Clinical Microbiology & Infectious Diseases in Lisbon, Portugal.

What support is there for long Covid sufferers?

Anyone who is suffering from persistent symptoms four or more weeks after having Covid is encouraged to seek advice from a GP.

A doctor may recommend some tests to find out more about the symptoms and to rule out other factors that could be causing them. This may include a blood test, checking your blood pressure and heart rate, or a chest X-ray.

You may be given advice to help manage and monitor symptoms at home, but if the effects are having a disruptive impact on your life, it is possible you may be referred to a specialist rehabilitation service, or a service that specialises in the specific symptoms you have.

More information to support your recovery can be found on the Your COVID Recovery website.