The study says that long-term symptoms of moderate Covid resolve within a year

CNN
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The majority of prolonged Covid symptoms resolve within the first year after infection for people with mild cases of Covid-19, according to a large study conducted in Israel.

“Mild disease does not lead to serious or long-term chronic morbidity in the vast majority of patients,” study co-author Barak Mizrahi, senior researcher at the KI Research Institute in Kafr Mellal, said via email.

studying, Published Wednesday in BMJ Magazine, Comparing thousands of vaccinated and unvaccinated people with mild Covid symptoms who were not hospitalized with people who tested positive for the virus. Long Covid is defined as symptoms that persist or appear more than four weeks after the initial infection with Covid-19.

“I think this study is reassuring because most persistent post-COVID symptoms improve within the first several months after acute infection,” said Dr. He did not participate in the study.

But not for everyone. Abramov said his clinic continues to see many patients with prolonged, severe Covid symptoms that last longer than one year after infection.

said Abramov, who leads the team American Academy of Physical Medicine and Rehabilitation Long Covid Collaborative.

Dr. Jonathan Whitson, associate professor of rehabilitation medicine at New York University Grossman School of Medicine, sees the same thing in his clinic.

“I continue to see many patients from the ‘first wave’ of COVID who had mild to moderate severe COVID (and were never hospitalized) and who developed persistent, functionally limited symptoms after about 3 years,” Whiteson said by email. He did not participate in the study.

The Israeli researchers analyzed the medical records of nearly 300,000 people diagnosed with mild cases of Covid-19 and compared their health over the following year with nearly 300,000 people who did not have Covid. The average age of those who tested positive for COVID was 25, and 51% were female.

The researchers looked for 65 cases associated with long Covid and divided them into two time frames: early, or the first 30 to 180 days after contracting Covid; and late, or 180 to 360 days after infection.

After controlling for age, gender, alcohol and tobacco use, pre-existing conditions, and various variants of Covid-19, the researchers found a high risk of brain fog, loss of smell and taste, breathing problems, dizziness, weakness, heart palpitations, and strep throat in the early and late periods.

The researchers said that chest pain, coughing, hair loss, muscle and joint pain, and respiratory disorders increased significantly only during the early stage.

The study found that difficulty breathing was the most common complaint. Vaccination reduced the risk of developing respiratory problems, but the researchers found that vaccinated individuals had “similar risks of other outcomes compared to unvaccinated infected patients,” according to the study.

“Given the size of the study, it was possible to look at the change in the prevalence of symptoms over time and the effects of other factors on persistent symptoms,” said Dr. Peter Openshaw, professor of experimental medicine at Imperial College London, in a statement. .

“Smell disorders usually resolve at about 9 months, but when they are present, the changes in concentration and memory tend to be more persistent,” said Openshaw, who was not involved in the study.

Only slight differences emerged between men and women in the study, but children had fewer early symptoms than adults, which mostly went away by the end of the year. No real differences were found between the original SARS-CoV-2 wild type (March 2020 to November 2020), Alternate Alpha (January 2021 through April 2021) and the delta variant (July 2021 until October 2021).

“Patients with mild COVID-19 have an increased risk for a small number of health outcomes, with only a few symptoms persisting a year after SARS-CoV-2 infection and their risk decreasing over time after infection,” Mizrahi said by email.

However, “we do not claim that there are no patients with prolonged COVID symptoms such as dyspnea (difficulty breathing), Weakness, cognitive impairment, etc. “(Our study) does not contradict the evidence that few patients experience long-term symptoms as shown in this analysis.”

The researchers pointed out certain limitations in the study, such as the potential for diagnostic errors or the failure to record some of the milder symptoms over time. Abramov agreed.

“The design of this study is unable to detect the severity of these symptoms, and it is possible that other patients are missed due to the use of medical coding to detect prolonged, persistent COVID symptoms,” said Abramov.

It may also be difficult to apply the study findings to other countries, such as the United States, due to differences in how doctors code symptoms. For example, the study did not identify many cases that are frequently found in long-term COVID clinics in the United States, said Dr. Monica Verduzco Gutierrez, associate professor and chief of rehabilitation medicine at Long College of Medicine at UT Health, San Antonio.

“The most common symptom of prolonged SARS-CoV-2 is fatigue, and that wasn’t on this list. Also missing was post-exertion malaise, dysarthria/Pots, or ME/CFS. Also missing was Verduzco Gutierrez, who was not involved in the new study, These are some of the key presentations I see in my clinic, so not having these results is a major limitation of this study.

Feeling of malaise after exertion It is overwhelming fatigue even after a small amount of effort. Unlike regular fatigue, it can take days to weeks for a person to recover, and malaise can be reactivated if activity is resumed too quickly.

Postural orthostatic tachycardia syndrome, or POTS, is a bump in heart rate after sitting or standing that can lead to dizziness or fainting. It is a form of autonomic imbalance, Autonomic nervous system disorder. “There is usually no cure for autonomic dysfunction,” he says. According to the National Institute of Neurological Disorders and Stroke.

Myalgic encephalomyelitis/chronic fatigue syndromeME/CFS, or ME/CFS, is a serious long-term illness in which people experience extreme fatigue that is not improved by rest. The condition can affect sleep and thinking processes, cause pain in many parts of the body, and prevent people from doing most daily activities.

In response to this concern, Mizrahi told CNN that “post-exertion malaise was not included in this study because it is not a commonly prescribed diagnosis in Israel.” In addition, he said, Dysautonomia/POTS was only assigned to the International Classification of Diseases, or ICD medical code, as of October 2022, so it was also not included in the study.

However, symptoms of POTS and other conditions may be included under general categories such as irregular heartbeat or heart palpitations, he said.

In addition, Mizrahi said, fatigue was coded under “weakness” in the study. In fact, the researchers found that weakness was the second most common symptom reported in the study, and it persisted in people ages 19 to 60 for several months.