Columbia University experts explain what we have learned about Long Covid
A very worthwhile article that explains the evolving knowledge of long covid. Among the revelations:
LP: Fortunately, we’re seeing less severe long COVID in the past several months. There are a few reasons contributing to this. First, it’s been shown that vaccination can help prevent long COVID. I also suspect that the new omicron variants have mutated to the point where they’re acting very different than the original virus and the delta variant. The omicron variants are mostly causing upper respiratory infections, so we’re seeing fewer pulmonary complications and also fewer neurocognitive issues and other symptoms, such as increased heart rate, lightheadedness, and chronic fatigue.
How many people develop long COVID after their initial infection?
LP: This is a tricky question to answer. It depends on how long COVID is defined. A lot of research studies use the criteria of having at least one symptom for more than 12 weeks after the acute infection. This definition is very broad and includes a lot of people who only report very mild symptoms such as mild fatigue or chronic nasal congestion. Studies that use a liberal definition report that between 20% and 80% of COVID patients develop long COVID, but those studies probably overestimate how many people have moderate to severe long COVID. Furthermore, many long COVID symptoms are commonly caused by other chronic conditions so it is important to confirm that they are actually due to COVID infection.
In reality, I think the burden of moderate to severe long COVID is much lower, along the lines of 1% to 5%. In our study with Columbia colleagues Michael Yin, Anne-Catrin Uhlemann, and David Ho, we find that at 12 weeks around 25% of COVID patients with lingering symptoms reported fatigue, 25% reported insomnia, and around 20% reported increased heart rate or dizziness, but only 15% reported neurocognitive deficits like difficulty with short-term memory. It is also important to note that the severity of these symptoms ranges from very mild to severely disabling.
For the majority of long COVID patients, the good news is that many have profound recovery by three to six months after their symptoms. Probably less than 10% have symptoms for longer than a year, and an even smaller percentage are still having symptoms that are considered moderate or severe for more than a year and half.
SR: I do think that many people with long COVID get better over time, and most data point to gradual improvement for many. However, the recovery can be slow with bouts of setback—for example, exertion from normal daily living or an unrelated illness can exacerbate preexisting long COVID symptoms. A minority of patients continue to have persistent long COVID symptoms. We need more research to shed insight into why some people recover fully and some don’t and how to tailor specific treatments to each long COVID patient.
https://www.cuimc.columbia.edu/news/what-have-we-learned-about-long-covid
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