Increased initial severity of COVID-19 correlates with an increased risk of longer-term complications and an increased use of health-care resources, suggests a Nature study publishing this week. The research, which provides a detailed description of the symptoms experienced up to six months later by over 87,000 users of the Veterans Health Administration in the United States who have recovered from the acute phase of COVID-19, could aid in the development of care strategies and health-system planning.
The acute symptoms of COVID-19 are well-characterized, but less is known about the long-term complications of infection with SARS-CoV-2. In this study, Ziyad Al-Aly and colleagues used data from the US Department of Veterans Affairs health-care databases to examine diagnoses, medication use and laboratory test results from 73,435 non-hospitalized and 13,654 hospitalized individuals up to 6 months after they had recovered from the acute phase of COVID-19.
The authors compared the outcomes of patients with COVID-19 who were non-hospitalized, hospitalized, or hospitalized and admitted to intensive care, and found an increasing risk gradient: those who had experienced the most severe forms of the disease were at greatest risk of additional COVID-related health issues at a later stage.
In addition, after the first 30 days of illness, all of the individuals with COVID-19 were found to have a higher risk of death and were more likely to require medical assistance for additional problems than nearly 5 million users of the Veterans Health Administration system who did not have COVID-19 and were not hospitalized. These included respiratory conditions, nervous system disorders, mental health problems, metabolic and cardiovascular disorders, malaise, fatigue, musculoskeletal pain and anaemia. Individuals experiencing long-term symptoms also showed an increased use of various medications, including antidepressants, anxiolytics (to reduce anxiety) and pain medications.
The authors note that although their study identifies the conditions that patients developed following COVID-19, they cannot determine whether these are direct or indirect effects of the disease.
After the embargo ends, the full paper will be available at: https://www.nature.com/articles/s41586-021-03553-9
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