Many people who experience long-term symptoms of the coronavirus did not feel bad at all when they were initially infected, according to a new study that adds compelling information to the increasingly important question of the lasting health effects of Covid-19.
The study, one of the first to focus exclusively on people who never had to be hospitalized when they were infected, analyzed electronic medical records of 1,407 people in California who tested positive for coronavirus. More than 60 days after their infection, 27% or 382 people struggle with symptoms after Covid such as shortness of breath, chest pain, cough or abdominal pain.
Understanding Covid’s long-term symptoms is an increasing priority for physicians and researchers as more people report disabling or painful consequences that interfere with their ability to work or function the way they did before. Last month, the director of the National Institutes of Health, Dr. Francis C. Collins, announced a major initiative “to identify the causes and ultimately the means of prevention and treatment of people with Covid-19 but not.” period of several weeks. “
David Putrino, director of rehabilitation innovations in Mount Sinai’s health system in New York, who is not involved in the new study, said he and his colleagues at the post-Kovid care center on Mount Sinai see a similar pattern.
“Many people who have had asymptomatic Covid may also develop post-acute Covid syndrome,” said Dr. 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 have no symptoms, but still have a very aggressive immune response.”
The new study was published on the MedRxiv prepress site and did not end with a peer review. Its strengths include that it is larger than many long-term symptom studies published so far, and that researchers have used electronic records from the University of California system, allowing them to obtain health and demographic information about patients across the state. The researchers also excluded from the study the symptoms that patients reported in the year before their infection, a step aimed at ensuring a focus on symptoms after Covid.
Among their findings: Long-term problems affect every age group, including children. “Of the 34 children in the study, 11 were long-haul carriers,” said one of the authors, Melissa Pinto, an associate professor of nursing at the University of California, Irvine.
The study found more than 30 symptoms, including anxiety, low back pain, fatigue, insomnia, gastrointestinal problems and a fast heartbeat. Researchers have identified five groups of symptoms that appear to be most likely to occur together, such as chest pain and cough or abdominal pain and headache.
Most previous studies of long-term symptoms usually include people who have been sick enough from their initial infection to be hospitalized. One of the largest found that more than three-quarters of about 1,700 hospitalized patients in Wuhan, China, had at least one symptom six months later.
But more and more people who have never been hospitalized are seeking care in clinics after Kovid, and scientists are realizing the need to understand their circumstances.
Last month, researchers at the University of Washington reported a study of 177 people who tested positive for coronavirus. Most of them were not hospitalized. About a third of people who were hospitalized and people who had only mild initial illnesses reported having at least one permanent symptom six months later, the researchers found.
Unlike some recent studies, such as one of the patient-led research teams, the new study does not cover one of the most commonly reported problems with long covid: cognitive problems such as brain fog, memory problems and difficulty concentrating. One of the co-authors, Natalie Lambert, an associate researcher at Indiana University School of Medicine, said this may be due to the fact that doctors at the time did not know they included diagnostic codes for such cognitive problems in medical records. patients with Covid. The team is seeking funding for a larger and more comprehensive study that combines information in medical records, doctors’ notes and patient reports, she said.
In the new study, about 59% of patients with long-term symptoms were women, and about half of the patients were Hispanic and 31% were white. The authors and Dr. Putrino warned that any credible demographic findings would require larger national surveys.
Dr. 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 sequelae of Covid. “For some people, if they are asymptomatic and don’t know they are sick, they won’t go for testing,” she said.
“Another important component is that we know that some of the symptoms of long distances appear much later than two months,” said Dr. Lambert. “So there’s the potential for a wide range of long-distance symptoms that they won’t associate with Covid.”
Dr Pinto said it would be important to study the condition over time instead of taking a static picture. “The long course is a very dynamic process and the symptoms can change from day to day,” she said. “One day they may have chest pain and headaches, and the next day the chest pains and headaches are gone and they have back and muscle pain. We need to capture the trajectory and change of symptoms over time, and we need that in a larger sample that represents America. “