Study: Half of Patients Hospitalized With COVID-19 Have at Least 1 Symptom 2 Years Later

Individuals who have recovered from the initial disease are in generally poorer health later on compared with the general population, the analysis shows.

Half of individuals who were admitted to the hospital with a COVID-19 infection still have at least 1 symptom after 2 years, according to results of the longest follow-up study to date.

The study, published in The Lancet Respiratory Medicine, included 1192 individuals in China who were infected with SARS-CoV-2 during the first phase of the pandemic in 2020.

The analysis suggested that individuals who had COVID-19 still tend to have poorer health and quality-of-life outcomes than the general population, especially for those who have long COVID, which was classified as still having at least 1 symptoms 2 years after initial infection.

“Our findings indicate that for a certain proportion of hospitalized COVID-19 survivors, while they may have cleared the initial infection, more than 2 years is needed to recover fully from COVID-19,” Bin Cao, MD, of the China-Japan Friendship Hospital in China, said in a statement.

“Ongoing follow-up of COVID-19 survivors, particularly those with symptoms of long COVID, is essential to understand the longer course of the illness, as is further exploration of the benefits of rehabilitation programs for recovery.”

The investigators of the study sought to analyze the long-term health outcomes of individuals who were hospitalized with COVID-19, as well as the implications of long COVID. They evaluated the health of 1192 individuals with acute COVID-19, who were treated at Jin Yin-tan Hospital in Wuhan, China, between January 7 and May 29, 2020. They evaluated the individuals at 6 months, 12 months, and 2 years.

The assessment involved laboratory tests, questionnaires, and a 6-minute walking test, looking at health care use after discharge, health-related quality of life, mental health, and whether they had returned to work.

The negative effects of long COVID, pertaining to exercise capacity, health care use, mental health, and quality of life, were determined by comparing individuals who did not have and had long COVID.

Health outcomes at 2 years were determined using age, comorbidities, and sex that were matched to a control group of individuals with no history of COVID-19 infection.

At 6 months after initial COVID-19 infection, approximately 68% of individuals reported at least 1 long COVID symptom. By 2 years, the reports of symptoms had fallen to approximately 55%. Fatigue or muscle weakness were the most reported symptoms and fell from 52% at 6 months to approximately 30% at 2 years.

Regardless of severity of their initial infection, 89% of individuals had returned to their original work at 2 years.

At 2 years after initial infection, individuals with COVID-19 reported generally poorer health, with 31% reporting fatigue or muscle weakness and 31% reporting sleep difficulties. The percentage of individuals who did not have a COVID-19 infection reported these symptoms at 5% and 14%, respectively.

Additionally, those with COVID-19 were more likely to report other symptoms, including dizziness, headaches, joint pain, and palpitations. In the questionnaires, approximately 12% of individuals with COVID-19 reported anxiety and depression and 23% of reported discomfort or pain compared with 5% and 5%, respectively, for individuals who did not have a COVID-19 infection.

Furthermore, approximately half of study participants had symptoms of long COVID at 2 years and reported lower quality of life than those who did not have long COVID. In the questionnaires, approximately 19% of individuals reported anxiety or depression, and 35% reported discomfort or pain, while those who did not experience long COVID reported these symptoms at 4% and 10%, respectively.

Additionally, 5% of individuals who had long COVID also experienced problems with their activity level at 4% and mobility at 5% compared with 2% and 1%, respectively, for those who did not experience long COVID.

The mental health assessment found that individuals with long COVID displayed symptoms of anxiety at 13% and symptoms of depression at 11% compared with those without long COVID at 3% and 1%, respectively.

Furthermore, those with long COVID used health care services more often at discharge, with 26% reporting an outpatient clinic visit compared with 11% of those without long COVID. Hospitalization was reported at 17% for those with long COVID and 10% for those without long COVID.

Investigators said their study had limitations, including lacking a control group of individuals who were in the hospital unrelated to a COVID-19 infection, which made it hard to determine whether observed abnormalities were specific to COVID-19.


The Lancet Respiratory Medicine: Two years after infection, half of people hospitalized with COVID-19 have at least one symptom, follow-up study suggests. EurekAlert. News release. May 11, 2022. Accessed May 12, 2022.