Study: Some COVID Survivors 'Sicker Than They Feel'

SAN FRANCISCO -- Amidst countless reports indicating that many people feel extremely debilitated from "long COVID" after surviving the infection, now comes a study indicating that some patients have the opposite experience.

Individuals who had been hospitalized with COVID-19 reported feeling progressively better over the 18 months after diagnosis, yet their performance in the 6-minute walk test worsened, reported Isabel Young, of NYU Langone Health in New York City.

"In other words, inpatient subjects are sicker than they feel," according to the poster she presented at the American Thoracic Society's annual meeting here.

The study was carried out among 330 people consecutively enrolled in NYU's post-COVID care program, which maintains a registry of its patients, including 192 whose illness did not require admission and 138 treated as inpatients. They were evaluated at months 1, 3, 6, 12, and 18 after diagnosis. Participants rated their own health status via the St. George's Respiratory Questionnaire (SGRQ), scored on a 100-point scale with higher numbers indicating worse health, and completed the 6-minute walk test.

Participants' mean age was 48 for previous outpatients and 56 for the inpatient group. Another difference between groups was that women predominated among outpatients (63%) while 60% of the former inpatients were men.

One month after diagnosis, median SGRQ scores for former inpatients stood at 36, gradually improving to a median of 27 by month 18.

But over the same span, their median 6-minute walk distance actually declined, from 387 to 310 meters. (In general, a 30-meter difference is considered clinically significant.)

Former outpatients, on the other hand, showed both improvement in SGRQ scores (median 49 falling to 38) and in 6-minute walk distance (391 increasing to 500 meters) over the 18 months after the infection was cleared. Intriguingly, these scores at month 1 suggest that the ex-outpatients felt worse than the inpatients in the immediate aftermath of COVID-19.

Young speculated that the previous inpatients, in completing the SGRQ, were "comparing their health to when they were in the hospital" suffering acute symptoms. For most, their current health was "comparatively much better than while admitted," she said.

Yet the worsening 6-minute walk performance over the following months points to worsening health.

She cautioned, however, that SGRQ and the 6-minute walk test may not tell the whole story. She told MedPage Today that lung function tests and imaging were also conducted in the study participants, and those data are still being analyzed.

Also, Young called attention to the older age for previous inpatients, "which may have an overall impact on mobility." And people enrolling in NYU's program may not be representative of the general COVID-19 survivor population.

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