Symptom-based scoring system may help diagnose long COVID
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Key takeaways:
- Roughly 10% of patients in a large study were determined to have long COVID based on a set of 12 symptoms.
- Researchers said identifying a diagnostic method could help improve treatment of long COVID.
Researchers created a symptom-based scoring system that may help diagnose long COVID more easily.
The scoring system is based on 12 common symptoms identified in a study that included almost 10,000 participants.
Long COVID is difficult to diagnose because it can include dozens of symptoms that vary between patients. It has also been challenging as a research subject, according to Leora I. Horwitz, MD, a professor of population health and medicine and director of the Center for Healthcare Innovation and Delivery Science at NYU Langone Health.
“The definition for long COVID is too general for scientists to use consistently across different studies,” Horwitz told Healio. “A more concrete definition is needed to help scientists better understand the causes of and treatments for long COVID. Eventually, more specific definitions like this will be useful and important for clinical care as well.”
In an effort to better characterize long COVID, Horwitz and colleagues enrolled more than 13,700 adults at 85 U.S. sites in a prospective observational cohort study before April 10, 2023, and surveyed them 6 months or more after they first experienced symptoms or were tested.
They analyzed data from a subset of 9,764 participants who met the selection criteria for the study, including 8,646 who tested positive for SARS-CoV-2 and 1,118 who tested negative.
Overall, there were 37 symptoms with a frequency of 2.5% or more or adjusted ORs of 1.5 or greater among people who tested positive, the researchers found. From these, they identified 12 symptoms that most set people with long COVID apart.
Their scoring system assigns points to each of these 12 symptoms: eight points for continued loss of smell or taste; seven points for postexertional malaise; four points for chronic cough; three points for brain fog or thirst; two points for palpitations or chest pain; and one point each for fatigue, changes in sexual desire or capacity, dizziness, gastrointestinal symptoms or abnormal movements.
Horwitz and colleagues established a threshold of 12 total points to identify people with long COVID. Based on this threshold, they determined that 10% (95% CI, 8.8%-11%) of the 2,231 participants first infected on or after Dec. 1, 2021, and enrolled in the study within 30 days of infection had long COVID.
According to Horwitz, the study reaffirmed that earlier strains and waves of SARS-CoV-2 were more likely to cause long COVID than the omicron variant. This, she said, is likely due to changes in the variants, as well as increased vaccination and effective treatments, “all of which reduce the severity of infection and probably therefore reduce the risk of long-term consequences.”
“While our findings are a big step forward in better characterizing and understanding the disease, further research is needed for use in clinical practice,” Horwitz said. “As a next step, researchers will explore adding information from lab tests and imaging to the definition.”
The research was funded by the NIH as part of its RECOVER initiative.
In a statement, Assistant U.S. Secretary of Health Rachel L. Levine, MD, said people with long COVID “want to understand what is happening with their bodies.”
“RECOVER ... is making great strides toward improving our understanding of long COVID and its associated conditions,” Levine said.
References:
- Large study provides scientists with deeper insight into long COVID symptoms. https://www.nih.gov/news-events/news-releases/large-study-provides-scientists-deeper-insight-into-long-covid-symptoms. Published May 25, 2023. Accessed May 25, 2023.
- Thaweethai T, et al. JAMA 2023;doi:10.1001/jama.2023.8823.
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