April 20, 2024

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The most reliable study: 1 in 8 COVID-19 patients will have long-term sequelae

The most reliable study: 1 in 8 COVID-19 patients will have long-term sequelae


The Lancet: The most reliable study to date shows that 1 in 8 COVID-19 patients will have long-term sequelae.

As of August 6, Pacific Time, the cumulative number of confirmed cases of COVID-19 pneumonia (COVID-19) in the world has exceeded 583 million.

Due to public health policies, vaccination and the application of antiviral therapy, and the mutation of the new coronavirus, the mortality rate of COVID-19 pneumonia has dropped significantly.

However, there are still some recovered patients who will continue to experience physical, psychological or cognitive symptoms, that is, long-term COVID-19 pneumonia sequelae , referred to as “long-term COVID-19” (Long Covid) .

Worldwide, the number of “long-term COVID-19” patients continues to increase.


According to the definition of the World Health Organization (WHO) , “long-term COVID-19” is a disease that people infected with the new coronavirus may face.

Symptoms often include fatigue, shortness of breath, dizziness, brain fog, and loss of smell or taste. “Long-term Covid-19” can last 3 months, 6 months, 9 months, or even longer, and the disease has been described as the next public health disaster on the horizon.

Therefore, data on the scale and extent of ‘long-term COVID-19’ symptoms are urgently needed to develop appropriate treatment strategies.


On August 6, 2022, Professor Judith GM Rosmalen of the University of Groningen in the Netherlands published a study entitled: Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study in the leading international medical journal The Lancet paper.


The study, based on a large population in the Netherlands, is the first to compare symptoms in “long-term Covid-19” patients with uninfected people, and measure the symptoms of individuals before and after contracting Covid-19. The study found that 1 in 8 survivors of Covid-19 develops “long-term Covid-19” symptoms .

Because the study included uninfected people, it helps to more accurately predict the prevalence of “long-term Covid-19” symptoms and thus better identify the core symptoms of this sequelae.


The most reliable study: 1 in 8 COVID-19 patients will have long-term sequelae



In the new study, the research team used data from Lifelines, a prospective cohort study of health and health-related behaviors in the Dutch population.

All participants aged 18 and older completed a 24-repeated digital questionnaire measuring 23 common symptoms associated with “long-term COVID-19” between March 2020 and August 2021.

Participants infected with 2019-nCoV during this period were infected with the Alpha strain (B.1.1.7) or earlier variant strains.

If the participating nucleic acid test results are positive, or if they are diagnosed with COVID-19 pneumonia in the hospital, they will be recorded as COVID-19 pneumonia patients.


In addition, most of the data was collected before the introduction of the Covid-19 vaccine in the Netherlands, which was not analyzed in the study due to the small number of vaccinated participants at that time.


Finally, 76,422 participants (60.8% women) with a mean age of 53.7 years were included in the study. Of these, 4,231 (5.5%) COVID-19 patients were matched for age, sex, and time with 8,462 control group participants.

The researchers recorded the severity of symptoms in COVID-19 patients before and after diagnosis and compared them with a matched control group.


Monitoring of symptom dynamics showed that during the acute phase of COVID-19, nearly all assessed symptom severity increased compared with controls .

Diarrhea and stomach pain, along with cold-like symptoms, returned to their pre-diagnosis severity within 50 days of diagnosis.

This suggests that these symptoms can be considered core symptoms of “long-term Covid-19”, mainly in the acute phase of the disease.


The most reliable study: 1 in 8 COVID-19 patients will have long-term sequelae



Core symptoms include chest pain, dyspnea, pain when breathing, muscle pain, loss of taste and/or smell, tingling hands/feet, sore throat, alternating heat and cold, heaviness in arms and/or legs , and general fatigue.

The average severity of these symptoms leveled off after 3 infections and did not worsen further.

Other symptoms that did not increase significantly in severity between 3 and 5 months after diagnosis included headache, itchy eyes, dizziness, back pain, and nausea.


Aranka Ballering , the first author of the study , said these core symptoms are of great significance for future research, as they can be used to distinguish the sequelae of Covid-19 from symptoms that are not related to Covid-19.


Among participants who submitted pre-diagnosis symptom data, the research team found that 21.4% (381/1782) of the Covid-19 patient group were 3 months or more after infection , compared with 8.7% (361/4130) of the control group , with at least one moderate increase in core symptom severity.

This suggests that in 12.7% of Covid-19 patients, an increase in the severity of core symptoms within 3 months of diagnosis can be attributed to SARS-CoV-2 infection.


Aranka Ballering said the long-term Covid-19 is an urgent issue that continues to cause human suffering.

Therefore, understanding the core symptoms and long-term prevalence of Covid-19 in the general population can ultimately aid in a successful response to the disease.


The research team said the study’s main strengths were the large sample size of COVID-19 patients identified in the general population cohort, and the multiple repeated measures of symptom severity in participants.

Therefore, it was possible to calculate the severity of symptoms for each participant prior to diagnosis.


However, the research team also said the study has some limitations.

For example, conducted in only one region and did not include an ethnically diverse population; and cases were infected with the Alpha strain ( B.1.1.7 ) or earlier SARS-CoV-2 variants, without the more impactful Delta or Omicron strains Data on infected people during the outbreak.

In addition, since asymptomatic infections account for a certain proportion, the prevalence of COVID-19 in this study may be underestimated.

To be clear, some symptoms such as ” brain fog ” have been identified as being associated with “long-term Covid-19” since the data collection began , but this study did not examine such symptoms.


The Lancet also published a review article titled: Long COVID: which symptoms can be attributed to SARS-CoV-2 infection?


The most reliable study: 1 in 8 COVID-19 patients will have long-term sequelae



The review article noted that this study is a significant advance on previous long-term estimates of the prevalence of sequelae of COVID-19, as it included matched uninfected groups and accounted for symptoms prior to the diagnosis of COVID-19.

The pattern of symptoms the team observed was similar to previous reports, with fatigue and dyspnea being the most common symptoms, but interestingly, other symptoms such as chest pain were more characteristic of long-term Covid-19 versus uninfected controls.

Current evidence supports the idea that prolonged COVID-19 is common and can persist for up to 2 years after infection, with a small number of people presenting with severe debilitating disease.

In conclusion, the definition of long-term COVID-19 cases requires further refinement, and a deeper understanding of its mechanisms is crucial to provide strategies for developing personalized, multimodal treatments.





Paper link:

The most reliable study: 1 in 8 COVID-19 patients will have long-term sequelae

(source:internet, reference only)

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