After COVID Discharge

According to the New England Journal of Medicine’s Journal Watch, “Researchers conducted an observational study that included 1,250 COVID-19 patients.” All were discharged from one of 38 Michigan hospitals between March and July 2020. Thirteen percent of patients were treated in intensive care units, and 70% required supplemental oxygen. The median age of the subjects was 62, and the median length of hospital stay was 5 days. About half of the patients were black. At 60 days after discharge, the scientists collected chart data and contacted 488 patients via telephone to gather more information on clinical, financial, and mental health outcomes.

The health outcomes alone were sobering. Seven percent of the patients had died, and 15% had been rehospitalized. Among the group, 33% had persistent symptoms related to their illness, and 20% had new or worsening symptoms. Forty percent had not yet returned to their normal activities. These statistics show just how long and serious a COVID diagnosis can be. But the effects of COVID extended far beyond the patients’ physical condition.

The researchers also asked about the patients’ emotional, work, and financial lives.

• Three quarters of those reached on the phone reported that they had been mildly or moderately emotionally affected. Six percent had sought mental health care for the emotional and mental distress that they had experienced.
• Among those employed before COVID-19, 40% were unable to return to work, primarily due to health reasons or job loss. Of those able to return to work, 25% had reduced hours or modified duties.
• Sixty-two percent of telephone respondents were mildly or moderately financially affected, and 10% had used up all or most of their savings. Six percent were unable to pay for necessities.

This study suggests that we have not yet fully realized the toll that COVID-19 takes on patients and their families. Researchers suspect COVID-19 may have an even greater cost to patients than other serious illnesses requiring hospitalization. COVID patients may be isolated long after their recovery and may even be stigmatized, which could lead to less optimal social, career, and financial prospects.

Researchers throughout medicine no doubt believe as I do; that this topic requires further investigation. Anyone can get COVID. For many, it is a serious illness and requires a long and arduous recovery. No one should suffer societal, emotional, professional, or financial harm in addition to the physical impact of this dangerous disease.  

Marie George, MD, FIDSA, is an infectious disease specialist at Southwestern Vermont Medical Center.