Let’s Talk About Long COVID – What Is It?

פוסט זה זמין גם ב: עברית

Written by Clay Smith

Spoon Feed
Patients with long COVID had a host of symptoms, poorer quality of life, and more anxiety and depression, but they did not have a specific cause identified for symptoms despite a comprehensive exam and battery of tests.

Why does this matter?
Many people are terrified they might get a mild case of COVID-19 yet face months or years of ongoing long COVID (aka postacute sequelae of SARS-CoV-2 infection, PASC). See CDC definition. Patients in this study recovered from asymptomatic to moderate COVID at least 4-6 weeks before enrollment and were asked about persistent symptoms. Is long COVID associated with long-term physical exam or testing abnormalities?

Anxiety and depression are real
This NIH study recruited 189 patients who were at least 4-6 weeks out from COVID-19 (12% hospitalized) and 120 negative controls. 55% of people who had COVID-19 reported PASC symptoms vs 13% of negative controls. Female gender and self-reported history of anxiety were associated with PASC. The most common PASC symptoms were: fatigue, dyspnea, anosmia/parosmia, concentration impairment, headache, memory impairment, insomnia, chest pain/discomfort, anxiety, myalgia, tinnitus, and palpitations. Despite having more symptoms, there were no abnormal physical exam findings (except muscle/tendon tenderness) and no laboratory, neurocognitive, cardiopulmonary, immunological or virological abnormalities in the COVID cohort compared to negative controls. However, patients in the COVID-19 cohort (driven by PASC patients) had lower quality of life scores and greater anxiety and depression scores. The study is limited by selection bias – PASC patients may have been more likely to enroll.

There is a lot we still don’t know about long COVID, and the NIH couldn’t test everything. But it’s reassuring there were no differences at 4-6 weeks in exam and testing between cohorts.

Another Spoonful

  • A new, massive UK primary care database study found several symptoms persisted ≥12 weeks after COVID: anosmia, hair loss, sneezing, ejaculation difficulty, reduced libido, shortness of breath at rest, fatigue, pleuritic chest pain, hoarse voice, and fever.
  • Thanks to the EMCrit RACC Lit Review. I overlooked this article, and their coverage brought it to my attention.

A Longitudinal Study of COVID-19 Sequelae and Immunity: Baseline Findings. Ann Intern Med. 2022 Jul;175(7):969-979. doi: 10.7326/M21-4905. Epub 2022 May 24.

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