//Long term COVID

Long term COVID

One in 20 people likely to suffer from ‘Long COVID’, but who are they?

https://covid.joinzoe.com/post/long-covid

https://www.theatlantic.com/health/archive/2020/08/long-haulers-covid-19-recognition-support-groups-symptoms/615382/

Symptoms were not serious enough to land them in hospital yet have persisted for many weeks or months

Hospitalised patients recognised to have lasting dyspnoea and fatigue in particular

Latest analysis of data

N = 4,182 users of the COVID Symptom Study app

Symptom Study app users, consistently logging their health, and positive by swab PCR testing

https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1

One in 20 people, symptoms lasting more than 8 weeks

How to predict long COVID

Symptoms

Age

Gender

BMI

Comorbidities

Accurately predict level of risk of developing long-term symptoms

Eleven days or less

Most people reported being back to normal

Symptoms lasting for at least 4 weeks

One in seven (13.3%, 558 users) 4 weeks

(14.5%)

Staying ill for 8 weeks

One in 20 (4.5%, 189 users) staying ill for 8 weeks

(51%)

Suffering for longer than 12 weeks

One in fifty (2.3%, 95 users)

(2.2%)

Who is most likely to get long COVID?

Age (strongest predictor)

Older people are much more likely than younger people

Does occur across all ages

Around 10% of 18 – 49 year olds

Around 22% of over 70s

Symptoms (second predictor)

More different symptoms in first week (16.3%)

More than 5 symptoms, OR, 3.95

Fatigue OR=2.83

Headache, OR=2.62

Dyspnoea OR=2.36

Hoarse voice OR=2.33

Myalgia OR=2.22

Symptoms aged over 70

Loss of smell was the most predictive, OR=7.35

Fever OR=5.51

Hoarse voice OR=4.03

BMI (third predictor, 10.8%)

Slightly higher average BMI

M/F (3.7%)

Men are more likely to be admitted to hospital

Women slightly more likely to suffer from long COVID

Men 9.5%

Women 14.5%

Comorbidities

Asthma

No clear links to any other underlying health conditions.

Long COVID symptoms

Fell into two broad groups

Group 1

Dominated by respiratory symptoms, cough, shortness of breath

Fatigue and headaches

Group 2

Multi-system

Affecting many parts of the body, brain, gut and heart

Palpitations

Fast heartbeat

Pins and needles or numbness

Problems concentrating (‘brain fog’)

People who experienced a wide range of symptoms across many body systems were more likely to need a hospital assessment

People with long COVID with recurrence of symptoms

16%

People with short COVID with recurrence of symptoms

8.4%

Predicting who will get long COVID

Model able to identify 69% of people who went on to get Long-Covid

i.e. predictive model has 69% sensitivity

Model was 73 % effective in avoiding false alarms

i.e. predicative model was 73% specific

Data checked with an independent dataset of 2,475 with positive coronavirus antibody test, similar results

App will give probability

Help target early interventions and research

Poorly-understood phenomenon.

The scale of the problem

Dr Claire Steves, King’s College

It’s important we use the knowledge we have gained from the first wave in the pandemic to reduce the long-term impact of the second

Thanks to the diligent logging of our contributors so far, this research could already pave the way for preventative and treatment strategies to reduce the long term effects

Using the app daily can help affected people and their doctors better categorise and judge their risks of developing longer more severe disease

We urge everyone to join the effort by downloading and sharing the app and taking just a minute every day to log your health

Tim Spector

COVID -19 is a mild illness for many

but for over one in 50 people symptoms can persist for longer than 12 weeks

So it’s important that, as well as worrying about excess deaths, we also need to consider those who will be affected by long COVID …

if we don’t get the pandemic under control soon

Having such large numbers of people affected means specialist services need to be set up urgently with the full financial help for hospitals and GPs

As we wait for a vaccine, it is vital that we all work together to stem the spread of coronavirus …

via lifestyle changes and more rigorous self isolating with symptoms or positive tests

Review of comorbidities in acute COVID

https://reference.medscape.com/viewarticle/939436_3

Risk factors for severe COVID-19, regardless of age, include the following:

Obesity (body mass index ≥ 30 kg/m2)

Chronic kidney disease

Chronic obstructive pulmonary disease (COPD)

Immunocompromised state due to solid organ transplant

Serious heart conditions (e.g. heart failure, coronary artery disease, cardiomyopathies)

Sickle cell disease

Type 1 diabetes mellitus

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