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- People with long-standing COVID experience persistent symptoms, such as fatigue and brain fog, that persist beyond the typical recovery period of 3 to 4 weeks after symptom onset.
- A recent study assessed the incidence of long-lasting COVID symptoms using data extracted from anonymized electronic health records.
- The study found that more than one in three people had long symptoms of COVID 3 to 6 months after being diagnosed with COVID-19.
- The study also reports that women, the elderly and those with severe illness during the initial stage of a SARS-CoV-2 infection had an increased likelihood of exhibiting long symptoms of COVID.
A majority of people recover from SARS-CoV-2 infection a few weeks after the onset of symptoms. However, a significant number of people continue to show symptoms of COVID-19 more than 3 to 4 weeks after contracting the virus.
Health experts refer to symptoms that persist beyond this acute phase of a SARS-CoV-2 infection as
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Several
For example, some of the studies used self-reported data collected using telephone or app-based surveys. In addition to the potential biases that accompany self-reports, the data collected in these studies was limited to patients who agreed to participate in the research.
Other studies have used follow-up data collected from people hospitalized with COVID-19 during the acute phase, limiting the generalizability of the results. In addition, many of these studies did not have a control group.
To address these shortcomings, a recent study led by a team of researchers from the University of Oxford in the UK used the anonymized medical records of 273,618 COVID-19 survivors to assess the risk of having long symptoms. COVID within 6 months of initial diagnosis. .
The presence of persistent symptoms following an acute infection, known as post-viral syndrome, is a common feature of other viral infections. To assess the specificity of long COVID symptoms, the researchers compared the incidence rate of long COVID symptoms after COVID-19 with those seen after influenza.
The study, published in the journal PLOS Medicine, found that more than a third of COVID-19 patients had long COVID symptoms 3-6 months after infection with SARS-CoV-2. Additionally, long symptoms of COVID were more common in women, the elderly, and people with severe symptoms during the acute phase.
The study also showed that long symptoms of COVID were more common in people with COVID-19 than in those with the flu.
“This is a very important study showing again that long COVID is common in people who have had COVID-19. They also did a comparative analysis and show that the risk of post-acute complications is much higher with COVID-19 than [with] seasonal flu, ”said Dr. Ziyad Al-Aly.
“The long COVID affects a lot of people. I am concerned that there are a lot of people who are not getting help, are not being diagnosed and are not getting the care they need. It is very important that we start to take this more seriously, ”added Dr Al-Aly.
Dr. Al-Aly is the research and education department head of the St. Louis veterans health care system in St. Louis, MO, and was not involved in the study.
There is currently a lack of consensus within the scientific community on the definition of long COVID and the time of onset of symptoms of long COVID. Therefore, the researchers used previous studies to identify the nine most common symptoms and diagnoses associated with long COVID.
These symptoms are:
Researchers assessed the incidence of these symptoms during the first 6 months after symptom onset. They also quantified the onset of these symptoms during the “long phase” of COVID-19, which was defined as the period between 90 and 180 days after diagnosis.
The study authors found that nearly 37% of individuals had at least one symptom of COVID long 3 to 6 months after infection with SARS-CoV-2.
Among people who experienced long symptoms of COVID during the long phase, about 60% also experienced one or more of these symptoms during the first 90 days.
In other words, the remaining 40% of this group of individuals who exhibited persistent symptoms of COVID-19 during the long phase did not exhibit any of these symptoms during the first 3 months.
The researchers found that certain symptoms, such as difficulty breathing, were more common in the first 3 months. On the other hand, symptoms such as anxiety and depression were more common during the long phase.
Similar to previous reports, people who suffered severe illness during the acute phase of infection had a higher risk of suffering a lengthy COVID.
Researchers also assessed the incidence of long COVID symptoms based on gender, age, and race.
Long symptoms of COVID were more common in women and the elderly. There was also a difference in the incidence of long COVID symptoms between different subgroups of patients.
Women and younger people were more likely to experience headaches, anxiety or depression, and abdominal symptoms than men and the elderly, respectively.
In contrast, cognitive symptoms and breathing difficulties were more common in the elderly and men. The elderly were also more likely to experience fatigue and pain than younger patients.
Notably, more than 46% of patients aged 10 to 21 had at least one long COVID symptom during the 6-month period after infection with SARS-CoV-2. Likewise, more than half of those who were out of hospital also experienced one or more long COVID symptoms.
Researchers found no significant difference in the appearance of long symptoms of COVID between white and non-white patients. The study’s first author, Dr Maxime Taquet, NIHR research fellow at the University of Oxford, said:
“The results confirm that a significant proportion of people of all ages can be affected by a range of symptoms and difficulties within 6 months of being infected with COVID-19. These data complement the results of self-report surveys and show that clinicians diagnose patients with these symptoms. We need appropriately configured services to meet current and future clinical needs. “
Symptoms such as fatigue and brain fog seen in long-term COVIDs also occur after the acute phase of other viral infections, including the flu. To study the specificity of these symptoms to COVID-19, the researchers compared the incidence of the nine long symptoms of COVID-19 with the flu.
The risk of incidence of any of the nine long symptoms of COVID during the long phase and the entire 6-month period after symptom onset was higher for COVID-19 than for influenza.
Additionally, many of the long symptoms of COVID were more likely to occur together after COVID-19 than after the flu.
This indicates that the incidence rate and pattern of onset of long-lasting COVID symptoms after COVID-19 may be distinct from those present after influenza.
One of the strengths of the study is the use of electronic health records rather than telephone surveys, thus providing access to a larger dataset. Additionally, electronic health records can also help assess the true impact of a long COVID on the healthcare system.
However, the authors acknowledge that the study had some limitations. One of the downsides to using electronic health records is the potential underestimation of long COVID cases. This is because some people with mild symptoms of long COVID may not have consulted a healthcare professional, resulting in the absence of a medical record.
Additionally, electronic health records have provided information primarily limited to the onset of long symptoms of COVID. Thus, the present study was unable to provide information on the severity and duration of these symptoms.
The authors also note that their analysis was limited to the most commonly described long COVID symptoms and therefore was not complete.
Dr Al-Aly noted: “The study is well conducted. One major limitation is that they only focused on nine characteristics of COVID-19. We know that the long COVID is a much broader condition and may involve many more characteristics than what was examined in this study. For example, they didn’t look at diabetes, heart disease, and kidney disease – all of these are known to be major issues along COVID. “
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