Infectious diseases

Long COVID partly inflammation driven: PHOSP-COVID

Systemic inflammation, and obesity, might be treatable traits in patients with long COVID and could potentially underpin a precision medicine approach to managing the condition, UK researchers say.

The study, published in The Lancet Respiratory Medicine, also revealed the extent of COVID-19’s long-term impact on patients, finding that only a “minority” of those hospitalised with the disease felt fully recovered one year after discharge.

For the prospective, observational study, researchers from the PHOSP-COVID Collaborative Group analysed data from 2,468 patients who had been hospitalised with COVID and completed 5-month and/or 1-year post discharge assessments.

The results showed little progress between the two assessment periods, with the proportion of patients reporting full recovery largely unchanged between 5 months (25.5% of 1965 patients) and 1 year (28.9% of 804 patients).

This indicates that a significant proportion of patients are being left with a substantial burden of symptoms, including reduced exercise capacity and diminished health-related quality of life, one year after being hospitalised for COVID-19.

Female sex, obesity and having had mechanical ventilation during the acute phase of illness were found to be the key risk factors holding back patient recovery, with odds ratios of 0.68, 0.50 and 0.42, respectively.

In addition, researchers found that several inflammatory mediators were significantly raised in those patients who had the most severe physical, mental health and cognitive impairments from long COVID compared to those with milder ongoing impairments,  highlighting a potential new avenue for treatment research.

“Inflammatory profiling in the study shows that a proportion of long COVID appears to be inflammation driven, and so trials of anti-inflammatory treatments should be considered,” Professor James Chalmers, a Consultant Respiratory Physician at the School of Medicine at the University of Dundee, and paper author, told the limbic.

However, he believes the key take home message from the study’s findings is that “we need to develop rehabilitation and treatment pathways for people post-hospitalisation which are evidence based. We urgently need to move from describing this problem, to finding solutions.”

The authors concluded that the findings “highlight an urgent need for healthcare services to support this large and rapidly increasing patient population”, and warned that “without effective treatments, long COVID could become a highly prevalent new long-term condition”.

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