SINGAPORE – A large-scale study covering 302 hospitals in Britain has found that half the patients hospitalised for Covid-19 suffered at least one complication, with some possibly leading to long-term health problems such as kidney failure.
The study, involving more than 73,000 patients aged 19 years and older, found that such complications occurred even in those who were young and healthy. It has just been published in the renowned British medical journal, The Lancet.
The article said: “Many of the complications identified are likely to have important long-term effects. Healthcare systems and policymakers should prepare for increases in population morbidity arising from Covid-19 and its subsequent complications.”
The most common complication was acute kidney injury, which the authors said “is known to be associated with increased long-term hazards of mortality, requirement for dialysis and an increase in cardiovascular events.”
Such injury was twice as likely to occur in patients already suffering from chronic kidney disease – affecting 40 per cent of them, compared with 22 per cent in patients with no prior kidney problems.
Similarly, cardiac complications affected 20 per cent of patients already with heart problems, against 9 per cent with no previous heart diseases.
While both kidney and heart complications were more common in older patients, liver injury appeared more often in younger cohorts.
Overall, 21 per cent of patients aged 19 to 29 years with no pre-existing diseases suffered at least one complication, compared with 58 per cent of patients aged 60 to 69 years who had two or more existing medical conditions.
Of those with complications, 60 per cent were men.
In the youngest cohort, those aged 19 to 29 years with no medical conditions, 28 per cent of men and 17 per cent of women suffered a post-infection complication.
The authors said: “This finding contradicts current narratives that Covid-19 is only dangerous in people with existing comorbidities and the elderly.”
Among previously healthy adults with no recorded medical problems, complications affected more than four in 10 hospitalised patients.
They added: “Patients with complications are also likely to have impaired ability to self-care following discharge from hospital.”
Following hospitalisation, 27 per cent of patients were less able to look after themselves than before getting Covid-19. This was more common among those of older age, who are male and received intensive care.
The authors suggested: “Policymakers and healthcare planners should anticipate that large amounts of health and social care resources will be required to support those who survive Covid-19.
“This includes adequate provision of staffing and equipment; for example, provision of follow-up clinics for those who have sustained in-hospital complications such as acute kidney injury or respiratory tract infection.”
Associate Professor Hsu Li Yang, an infectious diseases specialist at the National University of Singapore’s Saw Swee Hock School of Public Health, said it will be of great interest and value if even a subset of the surviving patients are followed up long-term.
“This large-scale UK study more accurately quantifies the various in-hospital complications and potential sequelae of serious Covid-19 infections, and in a more nuanced manner than the deaths and survivals that we are used to from government and press reports,” he said.
However, Professor Dale Fisher, a senior infectious diseases consultant at the National University Hospital, said he is not too concerned over the one in two suffering from complications as it refers only to those hospitalised, and not to all who were infected.
The solution, he said, is for as many people as possible to get vaccinated, as that is the best way to keep them from getting the disease, and hence long-term complications.
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