Many people who have long-term symptoms of the coronavirus did not feel bad when they were initially infected, according to a new study that adds compelling information to the increasingly important issue of COVID-19’s lasting health impact.
The study, one of the first to focus exclusively on people who never needed to be hospitalized when they became infected, looked at electronic medical records of 1,407 people in California who tested positive for coronavirus. More than 60 days after infection, 27%, or 382 people, were struggling with post-COVID symptoms, such as shortness of breath, chest pain, cough or abdominal pain.
Nearly a third of patients with these long-term problems had no symptoms from the initial coronavirus infection until 10 days after the positive test, the researchers found.
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Understanding long-term COVID symptoms is an increasingly urgent priority for doctors and researchers, as more and more people report debilitating or painful after-effects that hinder their ability to work or function the way they did before. Last month, the director of the National Institutes of Health, Dr. Francis S. Collins, announced a major initiative “to identify the causes and, ultimately, the means of preventing and treating individuals who have been infected with COVID-19, but it doesn t fully recover over a period of a few weeks. “
David Putrino, director of innovation in rehabilitation at Mount Sinai Health System in New York City, who was not involved in the new research, said he and his colleagues at the Mount Sinai center for post-COVID care are seeing a similar pattern.
“Many people who had asymptomatic COVID may also develop post-acute COVID syndrome,” said Putrino, who co-authored a smaller study on the subject published last year. “It doesn’t always match the severity of the acute symptoms, so you may not have symptoms, but still have a very aggressive immune response.”
The new study was published on the MedRxiv prepress website and has not yet been peer reviewed. Its strengths include that it is larger than many studies on long-term symptoms published so far and that the researchers used electronic records from the University of California system, allowing them to obtain demographic and health information from patients across the state. The researchers also excluded from the study the symptoms that patients reported in the year prior to the infection, a step that aims to ensure a focus on post-COVID symptoms.
Among his findings: Long-term problems affect all age groups, including children. “Of the 34 children in the study, 11 were long-distance,” said one of the authors, Melissa Pinto, an associate professor of nursing at the University of California at Irvine.
The study found more than 30 symptoms, including anxiety, low back pain, fatigue, insomnia, gastrointestinal problems and increased heart rate. The researchers identified five groups of symptoms that seemed most likely to occur together, such as chest pain and cough or abdominal pain and headache.
Most previous studies of long-term symptoms have tended to involve people who were sick enough since their initial infection to be hospitalized. One of the largest found that more than three quarters of the nearly 1,700 hospitalized patients in Wuhan, China, had at least one symptom six months later.
However, more and more, people who have never been hospitalized are seeking care in post-COVID clinics, and scientists are recognizing the need to understand their circumstances.
Last month, researchers at the University of Washington reported a survey of 177 people who tested positive for the coronavirus. Most of them had not been hospitalized. About a third of people who were hospitalized and those who had only mild early illnesses reported having at least one lasting symptom six months later, the researchers found.
Unlike some recent research, such as one conducted by a patient-led research team, the new study did not capture one of the most commonly reported “long COVID” problems: cognitive problems such as brain fog, memory problems and difficulty concentrating . One of the co-authors, Natalie Lambert, an associate research professor at Indiana University School of Medicine, said it may be because, at the time, doctors may not have known the inclusion of diagnostic codes for such cognitive problems in patient medical records. with COVID. . The team is seeking funding for a larger, more comprehensive study that combines information in medical records, medical notes and patient reports, she said.
In the new study, about 59% of patients with long-term symptoms were women, about half of the patients were Hispanic and 31% were white. The authors and Putrino warned that any credible demographic conclusions would require larger studies nationwide.
Lambert said the medical records used in the study were likely to reflect only a percentage of people who had asymptomatic COVID infections and had COVID sequelae. “For some people, if they are asymptomatic and do not know they are sick, they will not be tested,” she said.
“Another important component is that we know that some of the long-distance symptoms appear long after two months,” said Lambert. “So there is a potential for a wide range of long-distance symptoms that they are not going to associate with COVID.”
Pinto said it would be important to study the condition over time, rather than in a static snapshot. “Long distance is a very dynamic process and the symptoms can change from day to day,” she said. “One day they may experience chest pain and headache, and the next day, the chest pain and headache have disappeared and they have back and muscle pain. We need to capture the trajectory and the change in symptoms over time, and we need this in a larger sample that represents America ”.
This article was originally published in The New York Times.
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