Long COVID stemmed from mild cases of COVID-19 in most people

A woman wearing a medical mask is waiting for the bus
Enlarge / Long-term COVID-19 symptoms include fatigue, shortness of breath, and cognitive problems.

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big idea

Even mild cases of COVID-19 can have large and long-lasting effects on people’s health. This is one of the key findings of our recent multi-country study on long-term COVID-19 or long-term COVID, recently published in the Journal of the American Medical Association.

Long COVID is defined as the persistence or development of symptoms three months after initial infection with SARS-CoV-2, the virus that causes COVID-19. These symptoms last for at least two months after onset with no other explanation.

We found that a staggering 90 percent of people living with long-term COVID-19 had only mild illness with COVID-19 at baseline. However, after developing long-term COVID, a typical person has experienced symptoms such as fatigue, shortness of breath, and cognitive problems that affect daily functioning, such as brain fog or a combination of these. These symptoms have had as severe an impact on health as the long-term effects of traumatic brain injury. Our study also found that women are twice as likely to develop long-term COVID as men and four times more than children.

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We analyzed data from 54 studies reporting on more than 1 million people from 22 countries experiencing symptoms of COVID-19. We counted how many people with COVID-19 developed new clusters of long-term COVID symptoms and determined how their risk of developing the disease varied according to their age, gender, and whether they had been hospitalized for COVID-19.

We found that patients hospitalized for COVID-19 had a higher risk of developing long-term COVID and having longer-lasting symptoms compared to non-hospitalized patients. However, since the vast majority of COVID-19 cases do not require hospitalization, many more long-term cases of COVID have emerged than these milder cases despite their lower risk. Our study found that among all people with long-term COVID, about one in seven people still experience these symptoms a year later, and researchers don’t yet know how many of these cases may become chronic.

Long COVID can affect almost any organ in the body.

why is it important

Compared to COVID-19, relatively little has long been known about COVID.

Our systematic, multi-country analysis of this situation provided findings that illuminate the potentially high human and economic costs of prolonged COVID-19 worldwide. Many people living with this condition are working-age adults. Being unable to work for months can cause people to lose their income, livelihoods and housing. For parents or caregivers living with COVID for a long time, the situation can make them unable to care for their loved ones.

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Based on the prevalence and severity of prolonged COVID, we think it is keeping people from working and thus contributing to labor shortages. Long-term COVID may also be a factor in how people losing their jobs disproportionately affect women.

We believe that finding effective and affordable treatments for people living with long-term COVID should be a priority for researchers and research funders. Long COVID clinics have opened to provide specialized care, but the treatments they offer can be limited, inconsistent and costly.

what’s next

Prolonged COVID is a complex and dynamic situation; some symptoms disappear, then return and new symptoms appear. But researchers don’t yet know why.

While our study focused on the three most common symptoms associated with long-term COVID that affect daily functioning, the condition may also include symptoms such as loss of smell and taste, insomnia, gastrointestinal problems and headaches. In most cases, however, these additional symptoms appear alongside the main symptoms we predicted.

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There are many unanswered questions about what predisposes people to long-term COVID. For example, how do different risk factors, including smoking and a high body mass index, affect people’s likelihood of developing the condition? Does being reinfected with SARS-CoV-2 change the long-term risk of COVID? It’s also unclear how long-term protection against COVID changes over time after a person has been vaccinated or strengthened against COVID-19.

COVID-19 variants also introduce new puzzles. Researchers know that the omicron variant is less deadly than previous strains. Initial evidence suggests a lower long-term risk of COVID from omicron compared to previous strains, but much more data is needed.

Most of the people we studied were infected with more lethal variants that circulated before omicron became dominant. As part of the Global Burden of Disease study, which estimates death and disability from all diseases and injuries in every country in the world, we will continue to refine our research on long-term COVID to get a clearer picture of how this is happening. The long-term damage of COVID-19 changed when Omicron arrived.

Sarah Wulf Hanson is principal research scientist at Global Health Metrics, University of Washington, and Theo Vos is a professor of health metrics at the University of Washington.

This article has been republished under a Creative Commons license from The Conversation. Read the original article.

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