Research study reveals seven in ten patients hospitalised with COVID-19 not fully recovered five months post-discharge

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 this week.

Furthermore, one in five of the participant population reached the threshold for a new disability. 

At Manchester University NHS Foundation Trust (MFT), the study is taking place at the NIHR Manchester Clinical Research Facility (CRF) at Wythenshawe Hospital, a purpose-built unit dedicated to the delivery of world-class research.

The UK-wide study, PHOSP-COVID is led by the NIHR Leicester Biomedical Research Centre – a partnership between Leicester’s hospitals, the University of Leicester and Loughborough University – and jointly funded by the NIHR and UK Research and Innovation.

Nationally, researchers analysed 1,077 patients who were discharged from hospital between March and November 2020 following an episode of COVID-19. 

They found that each participant had an average of nine persistent symptoms. The 10 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, and slowed thinking.  

Study participants were also assessed for mental health. The study reports that more than 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.

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.

Professor Chris Brightling, a Professor of Respiratory Medicine at the University of Leicester and the national lead for the PHOSP-COVID study, said: “While the profile of patients being admitted to hospital with COVID-19 is disproportionately male and from an ethnic minority background, our study finds that those who have the most severe prolonged symptoms tend to be white women aged approximately 40 to 60 who have at least two long term health conditions, such as asthma or diabetes.” 

The researchers were able to the classify types of recovery into four different groups or ‘clusters’ based on the participants’ mental and physical health impairments.

One cluster group in particular showed impaired cognitive function, or what has colloquially been called ‘brain fog’. Patients in this group tended to be older and male. Cognitive impairment was striking even when taking education levels into account, suggesting a different underlying mechanism compared to other symptoms.   

The research has also uncovered a potential biological factor behind some post-COVID symptoms.

Respiratory Consultant, Dr Alex Horsley, is the Medical Director of Manchester CRF at Wythenshawe Hospital, as well as leading the study at the Hospital. He said: “Our Trust was the second highest recruiter nationally to this hugely important study – which is the first of its kind anywhere – and highlights need for research and treatment of post-COVID syndromes.

The high numbers of participants we’ve been able to recruit to PHOSP-COVID was only possible thanks to a huge effort by Research and Innovation colleagues across MFT, particularly at Manchester CRF at Wythenshawe Hospital.

“We have also had help from colleagues across many other clinical disciplines, and I’m really proud of how everyone has pulled together to deliver this.”

More about PHOSP-COVID

There are more than 300,000 post-hospitalisation survivors in the UK that have been discharged from hospital following COVID-19. While the study only represents a small sample of these patients, and participants are younger than the whole population in the UK that survived hospitalisation for COVID-19 infection, this is the largest study to report in detail on prospectively assessed outcomes across multiple UK centres to describe the impact of COVID-19 on medium term health of survivors.

Professor Chris Whitty, Chief Medical Officer and co-lead for the NIHR, said: “We are in the foothills of our understanding of long-term effects of COVID. This research provides useful information on the debilitating effects of COVID some people are living with months after being hospitalised.

“It is important that we work out what exactly the various elements of what is currently termed ‘Long COVID’ are so we can target actions to prevent and treat people suffering with long term effects.

Health and Social Care Secretary, Matt Hancock, said: “I know Long COVID can have a lasting and debilitating impact on the lives of those affected and I’m determined to improve the care we can provide.

Studies like this help us to rapidly build our understanding of the impact of the condition and we are working to develop new research so we can support and treat people.

“We are learning more about Long-COVID all the time and have given £20 million research funding to support innovative projects, with clinics established across the country to help improve the treatment available.”

Professor Fiona Watt, Executive Chair of the Medical Research Council, part of UKRI, said: “The initial findings from this study are that most patients hospitalised with Covid-19 are still suffering from effects of the disease five months on.

“Whilst this is clearly a concern, the new findings will help pave the way to improving patient recovery. The more we understand about what risk factors make someone less likely to recover fully, the better care and treatment we can offer to those patients who need it most.”

• You can read more about PHOSP COVID at MFT in our website news story.