Long Covid: Is the risk of long-term symptoms being underestimated?


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Some people continue to experience symptoms for a long time after COVID-19 infection

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If you are infected with coronavirus, how likely are you to develop long COVID? This is an important question, because its answer could affect individuals’ decisions about taking precautions against the virus, such as whether to wear a mask, and medical bodies’ decisions, such as who should be given booster vaccines.

Unfortunately, our scientific understanding of the condition has been poor throughout the pandemic. Long COVID is generally used as an umbrella term for any persistent symptoms following COVID-19 infection, usually those lasting three months or more. The most common include fatigue, shortness of breath, and difficulty concentrating, but some doctors say it includes more than 200 different symptoms.

Now, Tracy Beth Hoag at the University of California, San Francisco, and her colleagues claim that the likelihood of this condition has been underestimated. While some studies suggest that Long Covid affects up to half of those infected, this is due to their loose definition of the condition or poor design. The most authentic studies show that only a small percentage of people are affected, Hoegh says.

But critics of this analysis say researchers ignored other well-designed studies that support the idea that the virus often has lasting effects. Finding out how common this is Is it so difficult to get Long Covid?

Part of the problem is that we don’t know exactly what causes this condition. Several explanations have been proposed, including that the virus persists in the body or that it causes either overactivation or underactivation of the immune system – but it is unknown which of these, if any, Correct. Long COVID appears to have similarities with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), another mysterious syndrome of persistent fatigue that can arise after other infections.

Some studies of long Covid – often conducted before the pandemic – surveyed people whether they had any lasting symptoms after infection or whether they self-reported that they had long Covid.

This type of research is flawed, Hoegh says, because it’s common for people to have symptoms like fatigue despite infection. Instead, it is important to compare the rate of lingering COVID symptoms in people after infection with equivalent data from a control group of people who did not get the coronavirus, she says.

Some studies had control groups, but because of their design, people in these groups were in better health than those who were initially diagnosed with COVID-19, because people with poor underlying health were less likely to receive tests in hospital. There was more possibility of getting it done. If they develop COVID-19 symptoms. Hoegh says it will also increase the incidence of long Covid.

One of the most authoritative studies has been conducted by the UK Office for National Statistics, which asked large numbers of people to get regular COVID-19 tests whether they felt sick or not. It found that 5 per cent of people had one of 12 major long-term Covid symptoms three to four months after infection – but this was the case for 3.4 per cent of people who had not been infected. This suggests that 1.6 percent of people who get infected develop Long Covid.

“Studies that did not include control groups at all should not have been used for prevalence estimates of the still vaguely defined long COVID,” says Hoegh, “and it remains a mystery to me why they Why were they?”

She says media coverage of the research has led to high estimates, meaning many people still believe long Covid is more common than it actually is. “Articles based on fear get more attention,” she says.

However, the latest analysis is unlikely to settle the debate. Scientists who argue that Long Covid needs greater recognition and more research say the new claims are insulting to those who suffer from the condition. “Long Covid is a really complex thing and they are trying to simplify it somewhat,” says Stephen Griffin at the University of Leeds, UK, who is one of a group of scientists who want a rollback. Maximum COVID-19 precautions.

Jeremy Rossman at the University of Kent, UK, says the paper ignored some other well-designed studies that used control groups. For example, a man from Iceland estimated that 13 percent of people had one of the symptoms on the list eight months after infection and that these were severe enough to affect everyday life for a total of 7 percent. “They don’t define why some papers are used as examples, while other papers that fit their criteria but have higher dissemination rates are not discussed,” he says. .

Although the analysis does not claim to be a “systematic review”, it is a general type of scientific paper that aims to include all studies published on a topic. It also omitted other well-designed studies that support the claim of low prevalence, such as a study from Australia in August, which found that the incidence of long-lasting symptoms after three months was about the same as that of flu. The incidence was similar to that of COVID-19 — about 20 percent of cases with no symptoms at all and 4 percent of those that caused functional impairment.

In some ways, the exact number of people suffering from long Covid may not make much difference to those who have the condition. What they really want is to get better – and unfortunately, it tells us nothing about how to achieve this.

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