Post-COVID-19 Symptom Burden: What is Long-COVID and How Should We Manage It?

Sykes, Dominic L; Holdsworth, Luke; Jawad, Nadia; Gunasekera, Pumali; Morice, Alyn H.; Crooks, Michael G.

doi:10.21203/rs.3.rs-164000/v1

Cited by 86 publications

(150 citation statements)

References 11 publications

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“…We found that a large proportion of survivors of COVID-19 in our cohort had persistent symptoms 6 months after their initial illness. Although it has previously been reported that patients hospitalized for severe COVID-19 frequently suffer long-term symptoms [20][21][22][23] , we found that more than half of home-isolated, mildly to moderately ill patients with COVID-19 still suffered symptoms 6 months after infection. It is worrying that non-hospitalized, young people (16-30 years old) suffer potentially severe symptoms, such as concentration and memory problems, dyspnea and fatigue, half a year after infection.…”

Section: Discussioncontrasting

confidence: 81%

Long COVID in a prospective cohort of home-isolated patients

Blomberg

Mohn

Brokstad

et al. 2021

Nat Med

490

466

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Long-term complications after coronavirus disease 2019 (COVID-19) are common in hospitalized patients, but the spectrum of symptoms in milder cases needs further investigation. We conducted a long-term follow-up in a prospective cohort study of 312 patients—247 home-isolated and 65 hospitalized—comprising 82% of total cases in Bergen during the first pandemic wave in Norway. At 6 months, 61% (189/312) of all patients had persistent symptoms, which were independently associated with severity of initial illness, increased convalescent antibody titers and pre-existing chronic lung disease. We found that 52% (32/61) of home-isolated young adults, aged 16–30 years, had symptoms at 6 months, including loss of taste and/or smell (28%, 17/61), fatigue (21%, 13/61), dyspnea (13%, 8/61), impaired concentration (13%, 8/61) and memory problems (11%, 7/61). Our findings that young, home-isolated adults with mild COVID-19 are at risk of long-lasting dyspnea and cognitive symptoms highlight the importance of infection control measures, such as vaccination.

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Section: Discussioncontrasting

confidence: 81%

Long COVID in a prospective cohort of home-isolated patients

Blomberg

Mohn

Brokstad

et al. 2021

Nat Med

490

466

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“…Long COVID has been characterized by symptoms of fatigue, headache, dyspnea, cough, anosmia, etc., and has been more likely to occur in female sex in previous studies of adult populations. In the past couple of months, there have been a dozen publications on this syndrome [3][4][5][6], but little is known about its prevalence and its associated risk factors, specifically in children and adolescents. While there is no globally accepted terminology and definition for this syndrome, persistence of symptoms (e.g., fatigue, breathlessness, cough, joint pain, chest pain, muscle aches, headache, and so on, that could not be attributed to any other cause) beyond 2 weeks for mild disease, beyond 4 weeks for moderate to severe illness, and beyond 6 weeks for critically ill patients have been considered as "long COVID" [7].…”

Section: Introductionmentioning

confidence: 99%

Long COVID in children and adolescents

et al. 2021

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Background To identify the prevalence and also the full spectrum of symptoms/complaints of children and adolescents who are suffering from long COVID. Furthermore, we investigated the risk factors of long COVID in children and adolescents. Methods All consecutive children and adolescents who were referred to the hospitals anywhere in Fars province, Iran, from 19 February 2020 until 20 November 2020 were included. All patients had a confirmed diagnosis of COVID-19. In a phone call to patients/parents, at least 3 months after their discharge from the hospital, we obtained their current status and information if their parents agreed to participate. Results In total, 58 children and adolescents fulfilled the inclusion criteria. Twenty-six (44•8%) children/adolescents reported symptoms/complaints of long COVID. These symptoms included fatigue in 12 (21%), shortness of breath in 7 (12%), exercise intolerance in 7 (12%), weakness in 6 (10%), and walking intolerance in 5 (9%) individuals. Older age, muscle pain on admission, and intensive care unit admission were significantly associated with long COVID. Conclusions Long COVID is a frequent condition in children and adolescents. The scientific community should investigate and explore the pathophysiology of long COVID to ensure that these patients receive appropriate treatments for their condition.

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“…Increasing age, female sex, BMI, hospitalisation and co-morbidites have previously been identified as risk factors for Long COVID 6,25 . Our finding of a linear association between age and persistent symptoms in people with symptomatic COVID-19 contrasts with some other studies that suggest the highest prevalence is found in middle-aged groups.…”

Section: Discussionmentioning

confidence: 99%

Persistent symptoms following SARS-CoV-2 infection in a random community sample of 508,707 people

Whitaker

Elliott

Chadeau‐Hyam

et al. 2021

Preprint

119

130

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Introduction Long COVID, describing the long-term sequelae after SARS-CoV-2 infection, remains a poorly defined syndrome. There is uncertainty about its predisposing factors and the extent of the resultant public health burden, with estimates of prevalence and duration varying widely. Methods Within rounds 3-5 of the REACT-2 study, 508,707 people in the community in England were asked about a prior history of COVID-19 and the presence and duration of 29 different symptoms. We used uni- and multivariable models to identify predictors of persistence of symptoms (12 weeks or more). We estimated the prevalence of symptom persistence at 12 weeks, and used unsupervised learning to cluster individuals by symptoms experienced. Results Among the 508,707 participants, the weighted prevalence of self-reported COVID-19 was 19.2% (95% CI: 19.1,19.3). 37.7% of 76,155 symptomatic people post COVID-19 experienced at least one symptom, while 14.8% experienced three or more symptoms, lasting 12 weeks or more. This gives a weighted population prevalence of persistent symptoms of 5.75% (5.68, 5.81) for one and 2.22% (2.1, 2.26) for three or more symptoms. Almost a third of people 8,771/28,713 (30.5%) with at least one symptom lasting 12 weeks or more reported having had severe COVID-19 symptoms ('significant effect on my daily life') at the time of their illness, giving a weighted prevalence overall for this group of 1.72% (1.69,1.76). The prevalence of persistent symptoms was higher in women than men (OR: 1.51 [1.46,1.55]) and, conditional on reporting symptoms, risk of persistent symptoms increased linearly with age by 3.5 percentage points per decade of life. Obesity, smoking or vaping, hospitalisation , and deprivation were also associated with a higher probability of persistent symptoms, while Asian ethnicity was associated with a lower probability. Two stable clusters were identified based on symptoms that persisted for 12 weeks or more: in the largest cluster, tiredness predominated, while in the second there was a high prevalence of respiratory and related symptoms. Interpretation A substantial proportion of people with symptomatic COVID-19 go on to have persistent symptoms for 12 weeks or more, which is age-dependent. Clinicians need to be aware of the differing manifestations of Long COVID which may require tailored therapeutic approaches. Managing the long-term sequelae of SARS-CoV-2 infection in the population will remain a major challenge for health services in the next stage of the pandemic.

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Post-COVID-19 Symptom Burden: What is Long-COVID and How Should We Manage It?

Cited by 86 publications

References 11 publications

Long COVID in a prospective cohort of home-isolated patients

Long COVID in a prospective cohort of home-isolated patients

Long COVID in children and adolescents

Persistent symptoms following SARS-CoV-2 infection in a random community sample of 508,707 people

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