In a longitudinal cohort of 1,076 COVID-19 survivors discharged from two Wuhan hospitals, follow-up extended to four years. Median age was 58 years; about half were male.
Reinfection with SARS-CoV-2 occurred in 36.1% during December 2022–April 2023, with 21 cases of pneumonia and 14 hospitalisations attributed to reinfection. At least 12 months after reinfection, 12.1% reported sequelae, compared with 46.9% after the initial infection.
By four years post-discharge, 16.7% of participants reported long COVID–defined symptoms per WHO criteria, with fatigue, chest tightness, cough, and dyspnea being most common. Multivariate analysis identified abnormal fatigue (CIS ≥27) as associated with older age (per-year OR 1.020; 95% CI 1.007–1.034; p=0.003) and reinfection (OR 2.393; 95% CI 1.708–3.352; p<0.001).
The authors report that overall symptom burden at four years was lower than at earlier follow-ups for most survivors, but reinfection and older age remained linked to persistent symptoms. Some data are missing regarding specific outcomes at individual time points, and the study uses self-reported measures and predefined scales.
No treatment or management recommendations are provided.
BMJ Open published a clinical update in Research Highlights on 10 Apr 2026.
The item focuses on Health outcomes and reinfection among COVID-19 survivors 4 years after hospital discharge in Wuhan, China: a cohort study.
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