New study: More than half of those infected with the original strain of New Crown face moderate or more long-term sequelae after recovery

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On January 23, Lu Lin’s group at Peking University Sixth Hospital published a paper in Molecular Psychiatry titled “Phenotypes and Prediction of Long-term Physical and Mental Cognitive Sequelae after 20 Months of Recovery from New Guan Pneumonia – A Community-Based Chinese Cohort Study”.

Lu Lin, an academician, told CYP-China.com that the research team conducted a survey between October and November 2021 of community residents in Hongshan District, Wuhan, who had been infected with neocuan before December 2020, and found that more than half of those who recovered from neocuan had long-term sequelae 20 months after infection, and nearly one in six recovered had severe sequelae.

According to the clinical case definition of post-neoconiosis issued by the World Health Organization in October 2021, post-neoconiosis is defined as symptoms that appear 3 months after neoconiosis infection, last for a minimum of 2 months, and cannot be explained by another diagnosis. Symptoms of post-neoconiosis include fatigue, breathing difficulties, cognitive problems (forgetfulness or inattention, often referred to as “brain fog”), as well as loss of smell and taste, muscle pain, chest pain, palpitations, loss of appetite, depression, anxiety and other emotional problems that affect multiple systems throughout the body.

Lu Lin told the reporter that recovered patients with combined underlying diseases, history of psychiatric disorders, diagnosis of heavy or critical new crown and long hospitalization in the acute phase are more likely to suffer from severe sequelae; recovered patients younger than 60 years old with combined underlying diseases and diagnosis of heavy or critical new crown are more likely to suffer from moderate sequelae with mainly somatic symptoms, while women with long hospitalization in the acute phase are more likely to suffer from cognitive and mental symptoms.

Lu Lin further explained that according to the study, about 1 in 10 newly crowned recovered individuals had cognitive and psychiatric symptoms, mainly cognitive impairment, loss of smell and taste, dizziness, headache, depression, sleep problems, and post-traumatic stress disorder, where the cognitive impairment resulted in individuals feeling slowed down in thinking, poor concentration and memory loss.

For the newly crowned recovered individuals with different severity of sequelae, Lu Lin’s research team proposed different rehabilitation interventions: for nearly half of the group with no sequelae or mild sequelae, no special interventions are needed; for nearly 30% of the moderate sequelae group with mainly somatic symptoms, interventions such as physical therapy and rehabilitation training can be carried out to help recovered individuals improve their somatic functions; and for about 1/10 of the moderate sequelae group with mainly cognitive and mental symptoms, cognitive function training such as memory, attention and executive function can be carried out to improve cognitive problems, while psychotherapy or behavioral interventions can be carried out to improve mental health problems such as depression, anxiety, insomnia and post-traumatic stress disorder; for about 1/6 of the group with severe sequelae, a multidisciplinary collaborative and integrated intervention model should be adopted.

According to academician Lu Lin, this study has some reference and guiding significance for the recovery of the sequelae of the currently less pathogenic Omicron strain of infection. “This study focuses on exploring the long-term sequelae manifestations after infection with the original strain, and although the pathogenicity of the original strain is different from that of Omicron, the sequelae characteristics caused by both are somewhat similar, and the results of the study can provide guidance for the rehabilitation of sequelae in people infected with Omicron.”

Lu Lin told CYN that most studies on the sequelae of Omicron infection have found that the sequelae are fatigue, cough, breathing difficulties, depression, anxiety, and less research on cognitive impairment such as “brain fog”. However, it is also important to recognize that the follow-up period of studies on “long new crowns” after omicron infection is relatively short, and long-term follow-up is still needed to focus on the cognitive function of recovered patients.

“Despite the low pathogenicity of omicron, its long-term sequelae need to be taken into account due to the large number of infections. It is important to continue to conduct long-term sequelae follow-up studies in China for the Omicron strain as well as the original strain to explore the mechanism of occurrence of ‘long new crowns’ caused by the new coronavirus.” Lu Lin said.

It is reported that Zhao Yimiao, a master’s student at Peking University School of Public Health, Shi Le, an associate researcher at Peking University Sixth Hospital, and Dr. Jiang Zhendong, director of the Department of Psychotherapy at Wuhan Wuchang Hospital, are co-first authors of the paper, and Lu Lin, president of Peking University Sixth Hospital, Bao Yanping, an associate researcher at Peking University China Institute of Drug Dependence, and Professor Li Xiangyou, president of Wuhan Wuchang Hospital, are co-corresponding authors.