NEWS
Wuhan study highlights long-term effects of COVID
More than three quarters of COVID-19 patients have at least one ongoing symptom six months after initially becoming unwell, according to research published in The Lancet. The cohort study, looking at long-term effects of COVID-19 infection on people hospitalised in Wuhan, China, reveals that the most common symptom to persist is fatigue or muscle weakness (63% of patients), with patients also frequently experiencing sleep difficulties (26%). Anxiety or depression was reported among 23% of patients. Patients who were severely ill in hospital
more often had impaired lung function and abnormalities detected in chest imaging – which could indicate organ damage – six months after symptom onset. Levels of neutralising antibodies fell by more than half (52.5%) after six months in 94 patients whose immune response was tested at the peak of the infection, raising concerns about the possibility of being re- infected by the virus.
Little is known about the long-term health effects of COVID-19 as few follow-up studies have so far been carried out. Those that have been conducted looked only at a small number of cases over a short follow-up period (typically around three months after discharge). Professor Bin Cao, from the National Centre for Respiratory Medicine, China- Japan Friendship Hospital and Capital Medical University, said: “Because COVID-19 is such a new disease, we are only beginning to understand some of
its long-term effects on patients’ health. Our analysis indicates that most patients continue to live with at least some of the effects of the virus after leaving hospital, and highlights a need for post-discharge care, particularly for those who experience severe infections. Our work also underscores the importance of conducting longer follow-up studies in larger populations in order to understand the full spectrum of effects that COVID-19 can have on people.”
The new study included 1,733 COVID-19 patients who were discharged from Jin Yin- tan Hospital in Wuhan, China, between 7 January and 29 May 2020. Patients had a median age of 57 years. Follow-up visits were done from 16 June to 3 September 2020, and the median follow-up time was 186 days. At follow-up, 76% of patients (1,265/1,655) reported at least one ongoing symptom. Fatigue or muscle weakness was reported by 63% (1,038/1,655), while
26% (437/1,655) had sleep difficulties and 23% (367/1,733) experienced anxiety or depression. Patients with more severe illness commonly had reduced lung function, with 56% (48/86) of those at severity scale 5-6 (who required ventilation) experiencing diffusion impairment – reduced flow of oxygen from the lungs to the bloodstream. For patients at severity scale 4 (who required oxygen therapy) and those at scale 3 (who did not require oxygen therapy) the figures were 29% (48/165) and 22% (18/83), respectively. Patients with more severe disease
performed worse in the six-minute walking test (which measures the distance covered in six minutes), with 29% of those at severity scale 5–6 walking less than the lower limit of the normal range, compared with 24% for those at scale 3, and 22% for scale 4. The authors also found that some patients went on to develop kidney problems post-discharge. As well as the lungs, COVID-19 is known to affect other organs, including the kidney. Lab tests revealed that 13% (107/822) of patients whose kidney function was normal while in hospital had reduced kidney function in follow-up. Follow-up blood antibody tests from 94
patients after six months revealed that levels of neutralising antibodies were 52.5% lower than at the height of infection. The authors say this raises concerns about the possibility of COVID-19 re-infection. To view the study, visit:
www.thelancet.com/journals/lancet/ article/PIIS0140-6736(20)32656-8/fulltext
12,000 fewer heart operations performed in England
At least 12,000 fewer heart operations than expected took place in England in the year to November 2020, analysis from the British Heart Foundation (BHF) has revealed. The latest figures show the seismic impact of the pandemic on potentially life-saving surgery and other procedures for heart patients as the NHS is pushed to breaking point by surging COVID-19 cases. Around a third fewer heart operations than expected were performed by the end of November 2020 in England, the analysis found. In total, the number of heart operations, such as coronary bypass and heart valve surgery, fell to around 25,000 by the end of the November lockdown from 37,000 during the same period in 2019. Other invasive heart procedures, such as fitting stents or balloons to open blocked arteries, have been impacted too. In total, around 96,000 fewer heart operations and procedures than expected took place
in the year to November 2020 in England compared to the same period in 2019. Paradoxically, surgery and treatment waiting lists are shrinking at the same time as operation and procedure numbers are falling. Despite the NHS working all hours to prioritise the sickest patients, a lack of available non-COVID care means that fewer people are being added to waiting lists. There were 39,067 fewer people were on waiting lists for heart operations and procedures at the end of November in England compared to February 2020. Not only are there fewer people on waiting lists for heart surgery and other procedures, many of those on them are having to wait longer. The number of people waiting more than a year in England has soared to 2,800 – 100 times as many as there were in February 2020. Dr. Sonya Babu-Narayan, BHF’s associate medical director and consultant
12 l
WWW.CLINICALSERVICESJOURNAL.COM
cardiologist, commented: “The NHS is working on overdrive to prioritise all urgent COVID and non-COVID care. At the same time, we must not lose sight of people with heart conditions whose planned treatment has been delayed. “Surgery and other invasive procedures
to treat heart disease are not luxuries that people can easily go without – delaying them can cost lives. The significant backlog of people needing heart treatment will keep growing as COVID-19 cases soar. This may only be the tip of the iceberg as the true scale of the disruption to cardiovascular healthcare is still unknown. “The moment the current crisis abates, we need to urgently address the backlog of people waiting for treatment before it becomes too late for some. To do this, hospitals will inevitably need more and ongoing investment in heart and circulatory disease care.”
FEBRUARY 2021
©artegorov3@gmail -
stock.adobe.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72
