Long COVID Symptoms May Be Different Than Symptoms of Common Viral Respiratory Infections

Longer lasting symptoms of COVID-19 do not appear to occur more frequently than longer-lasting symptoms of other viral respiratory infections (VRIs), according to a study published in Open Forum Infectious Diseases. What differentiates symptoms of SARS-Cov-2 are the risk of heart palpitations, fatigue, joint pain, developing immune-mediated conditions, and the duration of symptoms post-infection; however, the data remains temporally limited, according to the study.

“The long-term clinical implications of SARS-CoV-2 infection are complex and will have ongoing significant impacts on quality of life and patient care,” the study authors wrote. “A better understanding of these implications will be important for patient care in the coming period due to the widespread and persistent nature of COVID-19 infection and the growing number of persons who have been infected.”

Long lasting COVID-19 symptoms (long COVID) are known to be fatigue, brain fog, and shortness of breath. But there are not many studies examining the other symptoms associated with long COVID-19, which may include persistent respiratory, cardiovascular, neurological, gastrointestinal, musculoskeletal, metabolic, and immune-mediated effects, as well as hair loss, excessive eating, or myocarditis, according to the authors of the current study. Symptoms of long COVID may also include lingering symptoms from infection or new medical diagnoses.

The investigators analyzed the long-term, persistent effects of COVID-19 on a large, diverse patient population who were not all hospitalized at infection. The investigators also evaluated the effects of other common viral respiratory infections.

Investigators evaluated 17,487 patients from US Cerner Real-World Data who were diagnosed with SARS-CoV-2 prior to April 14, 2022. Investigators discovered that the duration of symptoms differed between COVID-19 and common VRIs. A patient with fatigue, for example, may not recover for up to 1 year after initial infection.

Fatigue, body pain, and longer-lasting respiratory issues remained the core symptoms of COVID-19. Other characteristics of long COVID can include dyspnea and chest pain, whereas neurological effects do not appear higher in patients with long COVID compared to a common VRI.

The study was limited by patients diagnosed with generic VRIs. Additionally, females were over-represented, data include the post-Omicron period of the pandemic, the testing procedures were limited to the time period, geographic location may have led to bias, and the data were heterogeneous to the testing location.

Nearly 20% of US adults diagnosed with COVID-19 reported symptoms of long COVID, and 7.5% of infected adults experienced symptoms that lasted more than 3 months post-infection.

Subgroups stratified by geography, age, ethnicity, gender identity, and sexual orientation have also revealed a higher prevalence of long COVID in the state of Kentucky, or among middle aged adults, Hispanic women, and adults who are either transgender or bisexual.

“Understanding the population and subgroup risks for long COVID associated with outcomes… is important for clinicians and researchers, so that clinical guidelines for treatments and symptom management can be more appropriately developed for the growing number of adults affected by COVID-19,” the study authors wrote.

Reference

Baskett, W, Qureshi A, Shyu D, Armer J, Shyu C. COVID-Specific Long-term Sequelae in Comparison to Common Viral Respiratory Infections: An Analysis of 17 487 Infected Adult Patients. Open Forum Infectious Diseases. January 2023. Accessed February 8, 2023. doi.org/10.1093/ofid/ofac683