As the Pandemic Progresses, “Long COVID-19” is Poised for In-Depth Clinical Study

By the bioMérieux Connection Editors

As the COVID-19 pandemic continues to progress, there have been increasing reports of a phenomenon colloquially called “Long COVID-19,” where patients who have contracted the infection develop a range of symptoms lasting weeks or months, even when their infections were mild or asymptomatic. At first, reports were scattered and anecdotal—however, as they became more frequent, scientists and clinicians began to push for further study.

As with any novel disease, it is impossible to know all of the ways it will manifest in a population. Some effects are immediate, while others require time to appear—as is the case with Long COVID-19. The NIH recently launched a new initiative to study the issue, stating that, “While still being defined, these effects can be collectively referred to as Post-Acute Sequelae of SARS-CoV-2 infection (PASC). We do not know yet the magnitude of the problem, but given the number of individuals of all ages who have been or will be infected with SARS-CoV-2, the coronavirus that causes COVID-19, the public health impact could be profound.”

A pre-print systematic review and meta-analysis indicates that Long COVID-19, or PASC, could manifest in a wide range of ways and potentially affect a large majority of COVID-19 patients to some extent. The researchers write that, “It was estimated that 80% (95% CI 65-92) of the patients that were infected with SARS-CoV-2 developed one or more long-term symptoms.”

The most common symptom identified in both the meta-analysis and a separate patient cohort study published in The Lancet was fatigue, with 58% reported in the meta-analysis and 63% in the patient cohort study. Other symptoms commonly reported included sleep difficulties, anxiety or depression, headache, attention disorder, hair-loss, and difficulty breathing. While some of the symptoms are relatively mild, others are severe and could substantially impact patients’ lives. Without more robust information, mitigation and treatment will continue to be difficult.

The authors of the meta-analysis recommend that, “In order to have a better understanding, future studies need to stratify by sex, age, previous comorbidities, severity of COVID-19 (ranging from asymptomatic to severe), and duration of each symptom. From the clinical perspective, multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.”

The NIH’s initiative aims to address the need for additional data and hopes to answer some initial underlying questions:

  • What does the spectrum of recovery from SARS-CoV-2 infection look like across the population?
  • How many people continue to have symptoms of COVID-19, or even develop new symptoms, after acute SARS-CoV-2 infection?
  • What is the underlying biological cause of these prolonged symptoms?
  • What makes some people vulnerable to this but not others?
  • Does SARS-CoV-2 infection trigger changes in the body that increase the risk of other conditions, such as chronic heart or brain disorders?

Ideally, this research will lay the necessary groundwork for developing effective prevention, diagnostic, and treatment measures, as well as contribute to our broader understanding of viral illnesses and recovery from disease.

Opinions expressed in this article are not necessarily those of bioMérieux, Inc.

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