Evidence on medium to long term physical health impacts of COVID-19

This review aims to summarise the evidence on the longer-term physical health effects of COVID-19 after recovery from acute illness, and what NHS service support recovered patients will need.

A rapid review of online documents, resources and publications was conducted on 24 March 2020 and updated on 31 March 2020.

Overview of findings

There is very limited data on outcomes of patients following the recovery from the acute phase of COVID-19, reflecting how we are still only a few weeks into the pandemic.

Recovery rates fall with increasing disease severity, with an estimated 50 per cent survival following mechanical ventilation. Complications among patients on intensive care units (ICU) include cardiovascular events and acute renal injury and a proportion of those who survive ICU are likely to have ongoing medical needs in the short term.

A case series of ICU survivors of SARS CoV infection in 2002-3 identified that return to normal respiratory function took up to one year. Considerations for post-acute care include planning for a likely surge in demand for inpatient rehabilitation, outpatient rehabilitation, outpatient nursing care (including palliative care), supported discharge and home care services (including palliative care).

There is evidence from Italy of pressure on rehabilitation services due to recovering COVID-19 patients, and some available guidance documents for planning purposes. Specific considerations for rehabilitation services include:

• how to support home exercise during self-isolation eg through tele-rehabilitation
• how to implement appropriate infection control given likely vulnerability among rehabilitation patients
• how to ensure adequate PPE supplies for speech and swallowing therapists and chest physiotherapists
• how to appropriately decontaminate equipment

Citing this report

This report should be cited as:

NIHR Applied Research Collaboration (ARC) North Thames and UCLPartners. Evidence on medium to long term physical health impacts of COVID-19. 1 April 2020. Available from https://arcwestarchive.org.uk/research-and-implementation/covid-19-response/reports/evidence-on-medium-to-long-term-physical-health-impacts-of-covid-19/