Approximately 1 in 8 patients with COVID-19 experience long COVID
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Post-COVID, or long COVID, can develop in approximately one in eight people with COVID-19, according to data published in The Lancet.
“After recovery from acute COVID-19, a substantial proportion of patients continue to experience symptoms of a physical, psychological, or cognitive nature,” Aranka V. Ballering, MSc, of the department of psychiatry at the University Medical Center Groningen, in the Netherlands, and colleagues wrote. “These long-term sequelae of COVID-19 have been described as the next public health disaster in the making, and there is an urgent need for empirical data informing on the scale and scope of the problem to support the development of an adequate health-care response.”
To investigate the prevalence of long COVID, Ballering and colleagues analyzed data collected as part of the Lifelines COVID-19 cohort study. The specific cohort was an addition to the established Dutch Lifelines cohort study. There were no specific criteria for inclusion in the overall cohort, but exclusion criteria included “severe mental illness,” less than 5 years in remaining life expectancy at the time of enrollment, not being able to visit a doctor and not being able to fill out questionnaires in Dutch, the authors wrote.
Every participant in the original Lifelines cohort who was aged 18 years or older and had an associated email address was invited to participate in the COVID-19 cohort. The researchers included data from 24 consecutive measurements from participants in the Lifelines COVID-19 cohort. The questionnaires were administered between March 31, 2020, and Aug. 2, 2021. According to the authors, response rates for these questionnaires sat between 28% and 49%.
Participants were asked to complete digital surveys that covered multiple topics such as sociodemographic information as well as physical and mental health factors during the COVID-19 pandemic. Patients’ COVID-19 positivity was identified using a test or a physicians’ diagnosis.
The surveys investigated 23 symptoms, including headaches, dizziness, chest pain, back pain, nausea, painful muscles, breathing difficulty, feeling hot and cold alternately, tingling extremities, lump in the throat, general tiredness, heavy arms or legs, painful breathing, runny nose, sore throat, dry cough, wet cough, fever, diarrhea, stomach pain, ageusia or anosmia, sneezing and itchy eyes. The authors evaluated symptoms by calculating the mean score for each symptom in participants before COVID-19 diagnosis.
The analysis included 76,422 participants, of whom 4,231 had COVID-19 at one point. Participants who had COVID-19 were matched with 8,462 control participants. In patients who were positive, persistent symptoms at 90 to 150 days after COVID-19, compared with before COVID-19, and compared with matched controls, included chest pain, breathing difficulties, painful breathing, painful muscles, ageusia or anosmia, tingling extremities, lump in throat, feeling hot and cold alternately, heavy arms or legs, and general tiredness.
According to the researchers, these symptoms could be attributed to COVID-19 in 12.7% of patients, as 21.4% of 1,782 positive participants, compared with 8.7% of 4,130 negative controls, experienced at least one of these core symptoms substantially increasing to at least moderate severity at 90 to 150 days after COVID-19 diagnosis or matched timepoint.
“We present a starting point for core symptoms that could define post-COVID-19 condition, offer an improved working definition of post-COVID-19 condition, and provide a reliable prevalence estimate in the general population of the northern region of the Netherlands corrected for pre-existing symptoms and symptoms in participants without infection,” Ballering and colleagues wrote. “We found that about one in every eight patients are affected by persistent symptoms after COVID-19. This finding shows that post-COVID-19 condition is an urgent problem with a mounting human toll.”
References:
- Callard F, et al. Soc Sci Med. 2021;doi: 10.1016/j.socscimed.2020.113426.
- Crook H, et al. BMJ.2021;doi: 10.1136/bmj.n1648.
- Phillips S, et al. N Engl J Med. 2021;doi:10.1056/NEJMp2109285.
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