Around 650 million people have been infected with the SARS-CoV-2 coronavirus, which gives an idea of the importance for global public health of the fact that many of those infected have developed long-term sequelae, which it is known as persistent or prolonged COVID. Fatigue, intolerance to exertion, breathing difficulties or cognitive alterations are some of the more than 200 symptoms experienced by these patients. Now, a new study has identified 12 symptoms that would define prolonged COVID.
To better understand the prevalence and severity of symptoms that persist after infection, the National Institutes of Health (NIH) launched the Researching COVID to Enhance Recovery (RECOVER-Adult) study, and scientists from Mass General Brigham led the statistical analysis of it. RECOVER results have determined 12 symptoms that characterize prolonged COVID. The results have been published on the JAMA Network and include a new scoring system to help clinicians and researchers better define persistent COVID and investigate new treatments for those affected.
“Now that we can identify people with long-term COVID, we can start to do more in-depth studies to understand the biological mechanisms at play,” said Andrea Foulkes, RECOVER Data Resource Core (DRC) Principal Investigator, Professor at the School of Medicine. from Harvard and Director of Biostatistics at Massachusetts General Hospital (MGH) and a founding member of Mass General Brigham. “One of the big takeaways from this study is the heterogeneity of long-term COVID: long-term COVID is not just a syndrome; It is a syndrome of syndromes. Understanding this idea is a really important step in further research and ultimately delivering informed interventions,” she adds.
Increased risk of prolonged COVID in reinfected and unvaccinated
Although researchers have documented a wide range of organ system symptoms affecting people after COVID-19 illness, many studies are limited by a retrospective design, reliance on electronic health record inputs, and the lack of an uninfected comparison group. Thus, there remains significant disagreement about how common and/or severe certain long-term COVID symptoms may be, and what symptom patterns define long-term COVID.
“One of the big takeaways from this study is the heterogeneity of long-term COVID: long-term COVID is not just a syndrome; It is a syndrome of syndromes”
The RECOVER-Adult authors began recruiting participants in October 2021. Researchers at Mass General Brigham, RECOVER DRC, analyzed the results of a symptom survey distributed to 85 hospitals, health centers, and community organizations in 33 states, Washington, DC and Puerto Rico to which more than 9,500 people responded, including uninfected adults and individuals who had been infected with coronavirus for six months. The survey, developed in collaboration with physicians and patient advocates, included 37 different symptoms and corresponding measures of severity.
The researchers developed a simple algorithm that assessed 12 symptoms characteristic of prolonged COVID, including post-exertional malaise (debilitating fatigue that is intensified by physical or mental activity), loss or disturbances in smell or taste, dizziness, confusion mental illness, gastrointestinal disorders, palpitations, and chronic cough, to generate an overall “PASC score,” although those scientists stress that a person with symptoms excluded from the scoring system could also have long-term COVID and therefore should receive high-risk care. quality.
Some of the symptoms described, such as post-exertion malaise, are experienced by most people with persistent COVID, while others, such as loss or alterations in smell and taste, are less common but still important for identify people with prolonged COVID.
The results also suggest that reinfections, infection with a pre-omicron variant, and not being vaccinated are associated with increased frequency and severity of persistent COVID, but the authors stress that further research is needed. Future RECOVER Consortium studies will look at risk factors for long-term COVID, including social determinants of health. Researchers are also looking at how long COVID-19 can last in children, adolescents, and in women who were pregnant when they were infected with SARS-CoV-2.
“This is a truly data-driven approach to defining long-term COVID as a new syndrome,” said first author Tanayott Thaweethai, a RECOVER DRC co-investigator, instructor at Harvard Medical School, and associate director of MGH Biostatistics. “We now have a definition for long-term COVID where there hasn’t been one before, and we hope that the ability to identify long-term COVID will improve clinical awareness of this condition,” he concludes.
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