Long COVID: A growing problem in need of intervention

Blomberg, Björn; Langeland, Nina

doi:10.1016/j.xcrm.2022.100552

Cited by 19 publications

(31 citation statements)

References 17 publications

(17 reference statements)

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“…At the later stage of the pandemic, there are increasing reports of persistent symptoms after COVID-19, such as fatigue, concentration problems, and limb pain (muscle/joint). 62,63 Notably, consistent with recent findings on the increased risks of cardiovascular diseases 64 and long neuropsychiatric symptoms 65 , our results show a burst of attention to nervous and cardiovascular symptoms on social media in January 2022, which have continued growing. This alerts us to the emerging prolonged signs (long-COVID) 66 and their chronic burden on the nervous and cardiovascular systems.…”

Section: Discussionsupporting

confidence: 91%

Trend and co-occurrence network study of symptoms through social media: an example of COVID-19

Hua

et al. 2022

Preprint

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Importance: COVID-19 is a multi-organ disease with broad-spectrum manifestations. Clinical data-driven research can be difficult because many patients do not receive prompt diagnoses, treatment, and follow-up studies. Social medias accessibility, promptness, and rich information provide an opportunity for large-scale and long-term analyses, enabling a comprehensive symptom investigation to complement clinical studies. Objective: Present an efficient workflow to identify and study the characteristics and co-occurrences of COVID-19 symptoms using social media. Design, Setting, and Participants: This retrospective cohort study analyzed 471,553,966 COVID-19-related tweets from February 1, 2020, to April 30, 2022. A comprehensive lexicon of symptoms was used to filter tweets through rule-based methods. 948,478 tweets with self-reported symptoms from 689,551 Twitter users were identified for analysis. Main Outcomes and Measures: The overall trends of COVID-19 symptoms reported on Twitter were analyzed (separately by the Delta strain and the Omicron strain) using weekly new numbers, overall frequency, and temporal distribution of reported symptoms. A co-occurrence network was developed to investigate relationships between symptoms and affected organ systems. Results: The weekly quantity of self-reported symptoms has a high consistency (0.8528, P<0.0001) and one-week leading trend (0. 8802, P<0.0001) with new infections in four countries. We grouped 201 common symptoms (mentioned ≥ 10 times) into 10 affected systems. The frequency of symptoms showed dynamic changes as the pandemic progressed, from typical respiratory symptoms in the early stage to more musculoskeletal and nervous symptoms at later stages. When comparing symptoms reported during the Delta strain versus the Omicron variant, significant changes were observed, with dropped odd ratios of coma (95%CI 0.55-0.49, P<0.01) and anosmia (95%CI, 0.6-0.56), and more pain in the throat (95%CI, 1.86-1.96) and concentration problems (95%CI, 1.58-1.70). The co-occurrence network characterizes relationships among symptoms and affected systems, both intra-systemic, such as cough and sneezing (respiratory), and inter-systemic, such as alopecia (integumentary) and impotence (reproductive). Conclusions and Relevance: We found dynamic COVID-19 symptom evolution through self-reporting on social media and identified 201 symptoms from 10 affected systems. This demonstrates that social medias prevalence trends and co-occurrence networks can efficiently identify and study public health problems, such as common symptoms during pandemics.

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Section: Discussionsupporting

confidence: 91%

Trend and co-occurrence network study of symptoms through social media: an example of COVID-19

Hua

et al. 2022

Preprint

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“…4 Most cases resolve within two to four weeks of the initial symptoms' appearance; however, an increasing body of evidence shows long term sequelae, also referred to as long covid. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The clinical definition doi: 10.1136/bmj-2022-072529 | BMJ 2023;380:e072529 | the bmj of long covid is still evolving, but so far it has been defined as persistent symptoms or appearance of new symptoms beyond four weeks from the diagnosis of primary covid-19, which cannot be attributed to an alternative condition. 20 21 It may present with various multi-organ symptoms such as dyspnoea, fatigue, myalgia, cough, cognitive dysfunction, chest pain, and palpitations, which vary in prevalence and severity.…”

Section: Introductionmentioning

confidence: 99%

Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study

Mizrahi

Sudry

Flaks-Manov

et al. 2023

BMJ

197

135

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Objectives To determine the clinical sequelae of long covid for a year after infection in patients with mild disease and to evaluate its association with age, sex, SARS-CoV-2 variants, and vaccination status. Design Retrospective nationwide cohort study. Setting Electronic medical records from an Israeli nationwide healthcare organisation. Population 1 913 234 Maccabi Healthcare Services members of all ages who did a polymerase chain reaction test for SARS-CoV-2 between 1 March 2020 and 1 October 2021. Main outcome measures Risk of an evidence based list of 70 reported long covid outcomes in unvaccinated patients infected with SARS-CoV-2 matched to uninfected people, adjusted for age and sex and stratified by SARS-CoV-2 variants, and risk in patients with a breakthrough SARS-CoV-2 infection compared with unvaccinated infected controls. Risks were compared using hazard ratios and risk differences per 10 000 patients measured during the early (30-180 days) and late (180-360 days) time periods after infection. Results Covid-19 infection was significantly associated with increased risks in early and late periods for anosmia and dysgeusia (hazard ratio 4.59 (95% confidence interval 3.63 to 5.80), risk difference 19.6 (95% confidence interval 16.9 to 22.4) in early period; 2.96 (2.29 to 3.82), 11.0 (8.5 to 13.6) in late period), cognitive impairment (1.85 (1.58 to 2.17), 12.8, (9.6 to 16.1); 1.69 (1.45 to 1.96), 13.3 (9.4 to 17.3)), dyspnoea (1.79 (1.68 to 1.90), 85.7 (76.9 to 94.5); 1.30 (1.22 to 1.38), 35.4 (26.3 to 44.6)), weakness (1.78 (1.69 to 1.88), 108.5, 98.4 to 118.6; 1.30 (1.22 to 1.37), 50.2 (39.4 to 61.1)), and palpitations (1.49 (1.35 to 1.64), 22.1 (16.8 to 27.4); 1.16 (1.05 to 1.27), 8.3 (2.4 to 14.1)) and with significant but lower excess risk for streptococcal tonsillitis and dizziness. Hair loss, chest pain, cough, myalgia, and respiratory disorders were significantly increased only during the early phase. Male and female patients showed minor differences, and children had fewer outcomes than adults during the early phase of covid-19, which mostly resolved in the late period. Findings remained consistent across SARS-CoV-2 variants. Vaccinated patients with a breakthrough SARS-CoV-2 infection had a lower risk for dyspnoea and similar risk for other outcomes compared with unvaccinated infected patients. Conclusions This nationwide study suggests that patients with mild covid-19 are at risk for a small number of health outcomes, most of which are resolved within a year from diagnosis.

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“…Published studies were largely heterogeneous in design, size, population studied, length of follow up and disease definition, making very difficult to estimate the real prevalence and incidence of this condition (4,5). However, even assuming a populationbased prevalence for adults around 10% (roughly the center of the large interval of prevalences reported), Long-COVID will have a substantial public health and social impact, posing new challenges to the health systems, that will have to respond providing multidisclipinary care to a large number of patients presenting with an extreme clinical heterogeneity (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Long-COVID care centers in Italy. A national survey of 124 clinical sites

Floridia

Grassi

Giuliano

et al. 2022

Front. Public Health

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BackgroundDespite the growing clinical relevance of Long-COVID, there is minimal information available on the organizational response of health services to this condition.MethodsA national online survey of centers providing assistance for Long-COVID was implemented. Information collected included date of start of activity, target population, mode of assistance and of referral, type and number of specialists available, diagnostic and instrumental tests, use of telemedicine and of specific questionnaires.ResultsBetween February and May 2022, 124 centers completed the survey. Half of them were situated in northern Italy. Most (88.9%) provided assistance through either outpatient visits or day hospital services. Eleven (8.9%) assisted pediatric patients. Access to centers included scheduled visits for previously hospitalized patients (67.7%), referral from primary care (62.1%), from other specialists (46.8%), and, less commonly, from other services. Almost half of the centers (46.3%) started their activity early in the pandemics (March-September 2020). Almost all (93.5%) communicated with primary care physicians, and 21.8% used telemedicine tools. The mean number of patients followed was 40 per month (median 20, IQR 10-40). In most cases, the center coordinator was a specialist in respiratory diseases (30.6%), infectious diseases (28.2%), or internal medicine (25.0%). At least half of the centers had specialistic support in cardiology, respiratory diseases, radiology, infectious diseases, neurology and psychology, but roughly one quarter of centers had just only one (14.5%) or two (9.7%) specialists available. The clinical assessment was usually supported by a wide range of laboratory and instrumental diagnostics and by multidimensional evaluations.ConclusionsMost of the centers had an articulate and multidisciplinary approach to diagnosis and care of Long-COVID. However, a minority of centers provided only single or dual specialistic support. These findings may be of help in defining common standards, interventions and guidelines that can reduce gaps and heterogeneity in assistance to patients with Long-COVID.

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Long COVID: A growing problem in need of intervention

Cited by 19 publications

References 17 publications

Trend and co-occurrence network study of symptoms through social media: an example of COVID-19

Trend and co-occurrence network study of symptoms through social media: an example of COVID-19

Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study

Characteristics of Long-COVID care centers in Italy. A national survey of 124 clinical sites

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