The World Health Organization (WHO) estimates that persistent COVID – a set of symptoms or sequelae that persist for at least 12 weeks after the initial infection – will affect between 10% and 20% of people who have had COVID -19, which means that millions of people around the world will suffer from health problems, such as fatigue, mental fog, breathing difficulties, muscle aches or headaches, or anxiety, which can interfere with their daily lives.
Research has shown that prolonged or persistent COVID is causing severe and disabling symptoms, and a new study has found that those affected experience more fatigue and a greater deterioration in their quality of life than patients with some types of cancer. . Fatigue seems to be the predominant symptom and one of those that most influence the ability to perform daily tasks.
The study has been carried out by a team of researchers from the UCL Institute of Epidemiology and Health (London, United Kingdom) who in the summer of 2020 started a project to create a digital health intervention that would help clinics to provide remote assistance to patients with prolonged COVID. For two years, more than 8,000 patients from 35 NHS long-term COVID clinics used the Living With COVID Recovery mobile app.
“Prolonged COVID can have a devastating effect on patients’ lives, with fatigue having the biggest impact on everything from social activities to work”
Patients responded to questionnaires via the app reporting how long they had been affected by COVID, and its influence on their daily activities, levels of fatigue, depression, anxiety, breathing difficulties, and brain fog. In this way, patients were able to track their symptoms over time, while doctors were able to monitor and support their patients remotely.
The questionnaires also generated standardized scores for each symptom, allowing clinicians to compare persistent COVID scores with those of patients suffering from a variety of other illnesses that had been collected in previous research. Data from questionnaires completed by the first 3,754 patients using the app were analyzed by William Henley and Sarah Walker from the University of Exeter and the results are included in the study, which has been published in BMJ Open.
Long-term COVID patients who were critically ill
The researchers found that many patients with persistent COVID were severely ill and, on average, their fatigue scores were similar to or worse than those of people with cancer-related anemia or severe kidney disease. Their health-related quality of life scores were also lower than those of people with advanced metastatic cancers, such as stage IV lung cancer.
They found that overall, the impact of persistent COVID on patients’ daily activities was worse than that of stroke patients, and comparable to that of Parkinson’s disease patients. “Our results have found that prolonged COVID can have a devastating effect on patients’ lives, with fatigue having the greatest impact on everything from social activities to work, household chores, and maintaining close relationships.” said Dr Henry Goodfellow, who co-led the study with the late Professor Elizabeth Murray (both from UCL’s Institute of Epidemiology and Health).
The authors of the work have warned that the negative effects of Long COVID not only deteriorate the quality of life of those affected, but could also have a great economic and social impact. As they have noted, more than 90% of long-term COVID patients using the app were of working age (18-65) and 51% said they had been unable to work for at least one day in the previous month, while 20% were unable to work at all.
Additionally, 71% of patients were women and considering that women of working age make up the majority of the health and social care workforce, the impact of prolonged COVID on their ability to work may add additional pressures to services already saturated.
“Our findings show that fatigue should be an important focus for clinical care and the design of rehabilitation services. Post-COVID assessment services should consider focusing on assessing and treating fatigue to maximize recovery and return to work for patients with prolonged COVID,” warns Dr. Goodfellow.
“Long-term COVID is an invisible condition and surprisingly our research has revealed that it can leave people with worse fatigue and quality of life than some cancers, but support and understanding is not on the same level. We urgently need more research to enable the development of evidence-based services to support people trying to manage this debilitating new condition,” concludes Professor William Henley, from the University of Exeter Medical School and co-author of the study.
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