Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact

Abstract

Objective. To characterize the symptom profile and time course in patients with Long COVID, along with the impact on daily life, work, and return to baseline health.Design. International web-based survey of suspected and confirmed COVID-19 cases with illness lasting over 28 days and onset prior to June 2020. Setting. Survey distribution via online COVID-19 support groups and social mediaParticipants. 3,762 respondents from 56 countries completed the survey. 1166 (33.7%) were 40-49 years old, 937 (27.1%) were 50-59 years old, and 905 (26.1%) were 30-39 years old. 2961 (78.9%) were women, 718 (19.1%) were men, and 63 (1.7%) were nonbinary. 8.4% reported being hospitalized. 27% reported receiving a laboratory-confirmed diagnosis of COVID-19. 96% reported symptoms beyond 90 days.Results. Prevalence of 205 symptoms in 10 organ systems was estimated in this cohort, with 66 symptoms traced over seven months. Respondents experienced symptoms in an average of 9.08 (95% confidence interval 9.04 to 9.13) organ systems. The most frequent symptoms reported after month 6 were: fatigue (77.7%, 74.9% to 80.3%), post-exertional malaise (72.2%, 69.3% to 75.0%), and cognitive dysfunction (55.4%, 52.4% to 58.8%). These three symptoms were also the three most commonly reported overall. In those who recovered in less than 90 days, the average number of symptoms peaked at week 2 (11.4, 9.4 to 13.6), and in those who did not recover in 90 days, the average number of symptoms peaked at month 2 (17.2, 16.5 to 17.8). Respondents with symptoms over 6 months experienced an average of 13.8 (12.7 to 14.9) symptoms in month 7. 85.9% (84.8% to 87.0%) experienced relapses, with exercise, physical or mental activity, and stress as the main triggers. 86.7% (85.6% to 92.5%) of unrecovered respondents were experiencing fatigue at the time of survey, compared to 44.7% (38.5% to 50.5%) of recovered respondents. 45.2% (42.9% to 47.2%) reported requiring a reduced work schedule compared to pre-illness and 22.3% (20.5% to 24.3%) were not working at the time of survey due to their health conditions. Conclusions.Patients with Long COVID report prolonged multisystem involvement and significant disability. Most had not returned to previous levels of work by 6 months. Many patients are not recovered by 7 months, and continue to experience significant symptom burden..

Factors shaping the mental health and well-being of people experiencing persistent COVID-19 symptoms or ‘long COVID’: qualitative study

“…For many people, symptoms persist far beyond the acute phase of the disease. [1][2][3] Various names have been given to this condition, including ongoing symptomatic COVID-19, post-acute COVID-19 syndrome, 'long-haulers' and 'long COVID'. 1,4 Here we use the term long COVID, as it has become popular among many people with the condition and is widely used in the medical literature; 1 however, we appreciate that discussions continue.…”

“…6 Current research suggests that approximately 10% of people in the UK will have ongoing symptoms 12 weeks after initial infection, and substantial numbers have symptoms lasting over 6 months. 1,3 There is a growing burden of ill health from long COVID in the UK, alongside patient reports that their needs are not currently being met by existing health services. 7 Long COVID symptoms can be variable and wide-ranging, relating to multiple organ systems, including respiratory, cardiovascular, neurological, psychological/psychiatric, gastrointestinal, musculoskeletal and dermatological; or they can be general and non-specific.…”

Data-Driven Analysis of COVID-19 Reveals Persistent Immune Abnormalities in Convalescent Severe Individuals

“…Upon clearance of SARS-CoV-2, a sizeable number of recovered patients may exhibit lingering immune responses, which are believed to be responsible for long-COVID symptoms, including extreme fatigue, brain fogs and depression (13,14). Ongoing inflammatory processes or aberrant immune responses can collectively contribute to clinical manifestations due to cellular and molecular damages of COVID-19 (15).…”

Case Report of Breakthrough Long COVID and the Use of Nirmatrelvir-Ritonavir

“…This case is a cautionary tale that demonstrates PASC can still occur in vaccinated individuals who develop breakthrough COVID-19 infection. The symptomatology, prolonged duration, and functional debilitation experienced by this patient are similar to that seen in many unvaccinated individuals with PASC [4]. We suspect that her initial infection was likely the Delta variant of SARS-CoV-2 based on time frame, but we do not have con rmatory data in this case.…”