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USC researchers identify symptoms associated with increased risk of prolonged COVID

Since the start of the pandemic, patients and clinicians alike have been frustrated by the sizable minority of coronavirus infections that develop into prolonged COVID, a bewildering collection of persistent and often disabling symptoms that persist for weeks, months or even longer. years after the initial infection clears.

The condition has been reported in both children and adults; in those who had pre-existing conditions and those in robust health; in hospitalized COVID-19 patients and those who experienced only mild symptoms during their initial infection.

A new study from USC researchers offers some insights into the prevalence of long-term COVID and suggests some early clues about who might be more likely to develop long-term symptoms.

The study, published this month in Scientific Reports, found that 23% of people who had coronavirus infections between March 2020 and March 2021 were still reporting symptoms up to 12 weeks later.

The researchers recruited approximately 8,000 people, some infected and some not, to answer biweekly questions about their general health and COVID-19. At the end of the one-year survey period, they had a sample of 308 people who had contracted the disease at some point in the year.

After filtering out respondents with symptoms such as headache and fatigue prior to infection as a result of unrelated conditions such as seasonal allergies, the team found that nearly 1 in 4 COVID-19 patients were still dealing with symptoms 12 weeks after infection.

“These people cannot necessarily do all the activities that they would like to do, they cannot fully work and take care of their families,” he said. Eileen Crimminsdemographer at the USC Leonard Davis School of Gerontology and co-author of the study.

“That’s one aspect of this disease that needs to be recognized, because it’s really not as benign as some people think,” he said. “Even people who have relatively few symptoms early on can end up with prolonged COVID.”

Determining who is most at risk for prolonged COVID has proven challenging for demographers and health care providers.

Several previous studies have identified women as most at risk. But the USC study found no relationship in its sample between prolonged COVID and age, gender, race, or pre-existing health conditions, such as cancer, diabetes, high blood pressure, and heart disease.

He did note an increased risk in patients who were obese before infection. And it also found some associations between the specific symptoms people experienced during their initial infection and the likelihood of developing prolonged COVID. Patients who reported sore throats, headaches and, interestingly, hair loss after testing positive were more likely to have persistent symptoms months later.

“Our assumption is that hair loss reflects extreme stress, potentially a reaction to high fever or medications,” Crimmins said. “So it’s probably an indication of the severity of the disease.”

Because it covered only the first year of the pandemic, the study does not take into account two important developments: vaccines and variants. None of the COVID-19 patients in the sample were eligible for vaccinations during the study period, and all were infected before the UK Alpha variant reached US shores.

While the 308 survey respondents were representative of the population, no single snapshot of a few hundred people can tell the full story of the population. approximately 200 million people in the US who have had the virus, according to estimates from the Centers for Disease Control and Prevention.

“The authors made a commendable effort to identify factors associated with long duration of COVID,” he said. dr Alain Lekoubou Looti, a neurologist at Penn State University who was not involved in the study. “However, these factors may need to be confirmed in larger samples.”

The most common prolonged COVID symptoms reported were headache, nasal congestion, abdominal pain, fatigue, and diarrhea. But the study didn’t address many of the symptoms that people living with long-term COVID describe as the most debilitating, said Hannah Davis, co-founder of the Patient-led research collaborationa research group that focuses on the condition.

“We need work like this, but this work also indicates that they are not very familiar with the duration of COVID,” Davis said. “The list of symptoms are predominantly acute COVID symptoms and do not include the more common symptoms of post-exertional malaise, cognitive dysfunction, memory loss, sensorimotor symptoms, and others.”

Defining COVID long presents a challenge for those trying to track or treat it. COVID-19 is a chimerical beast: symptoms evolve as the condition drags on and can vary widely between patients.

The fluidity of prolonged COVID makes it difficult to measure its prevalence. Several studies have placed the percentage of people reporting lasting symptoms 12 weeks after their initial infection anywhere between 3% a fifty%.

“We need a universal case definition before we can really understand the prevalence of prolonged COVID. Right now, the definition varies greatly between studies, leading to a wide range in prevalence estimates,” he said. jana hirschtick, an epidemiologist at the University of Michigan School of Public Health. “After all this time, we still don’t have a clear picture of who is most at risk.”

The absence of strict diagnostic criteria is also a major problem for patients trying to seek treatment. At the moment, prolonged COVID is considered an “exclusive diagnosis,” meaning one given only after all other valid possibilities have been ruled out, he said. melissa pinto, to an associate professor of nursing at UC Irvine who studies the condition. In the US, that can mean a long and expensive process of undergoing various tests and specialists.

For many long COVID patients, 12 weeks is just the beginning of a months or years ordeal.

“I know people who have had this for two and a half years,” Pinto said. “There’s really no safety net for these people.”

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