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More than half of COVID survivors have symptoms 6 months later

To date, the global COVID-19 pandemic that began in late 2019 has caused more than 240 million infections and nearly five million deaths. Although the vast majority (98 percent) of those who become infected with SARS-CoV-2 survive, the consequences of the infection may linger for many months. 

A new study into the long-term health consequences for COVID survivors, conducted by researchers from the Penn State College of Medicine, has found that more than half of all survivors will experience post-COVID symptoms – known as “long COVID” – up to six months after recovering. The researchers suggest several ways in which public health professionals, governments and health care organizations should prepare for the needs of these survivors.

The researchers assessed 2,100 published studies concerning COVID survivors who reported post-recovery symptoms or illnesses. Of these, they selected 57 studies for inclusion in their review. Overall, they included data from 250,351 unvaccinated adults and children who were diagnosed with COVID-19 between December 2019 and March 2021, and who suffered post-recovery symptoms. The researchers analyzed survivors’ health during three intervals; at one month (short-term), two to five months (intermediate-term) and six or more months (long-term) after recovery.

Thirty-eight different clinical manifestations of symptoms were considered, and were grouped into the following categories: (1) organ systems, i.e, neurologic, mental health, respiratory, cardiovascular, digestive, dermatologic, and ear, nose, and throat; (2) constitutional symptoms; and (3) functional mobility.

According to the findings, survivors manifested a variety of health issues associated with COVID-19. Generally, these complications affected a patient’s general well-being, their mobility or organ systems. The rates remained largely constant from one month through six or more months after their initial illness. 

The investigators noted several trends among survivors, such as:

  • General well-being: More than half of all patients reported weight loss, fatigue, fever or pain.
  • Mobility: Roughly one in five survivors experienced a decrease in mobility.
  • Mental health disorders: Nearly one in three patients was diagnosed with generalized anxiety disorder.
  • Neurologic concerns: Nearly one in four survivors experienced difficulty concentrating.
  • Lung abnormalities: Three in five survivors had chest image abnormalities and more than a quarter of patients had difficulty breathing.
  • Cardiovascular issues: Chest pain and palpitations were among the commonly reported conditions.
  • Skin conditions: Nearly one in five patients experienced hair loss or rashes.
  • Digestive issues: Stomach pain, lack of appetite, diarrhea and vomiting were among the commonly reported conditions.

“These findings confirm what many health care workers and COVID-19 survivors have been claiming, namely, that adverse health effects from COVID-19 can linger,” said co-lead investigator Vernon Chinchilli, chair of the Department of Public Health Sciences. “Although previous studies have examined the prevalence of long COVID symptoms among patients, this study examined a larger population, including people in high-, middle- and low-income countries, and examined many more symptoms. Therefore, we believe our findings are quite robust given the available data.”

It is clear from the results of this review, published this week in the Journal of the American Medical Association, Network Open, that COVID-19 survivors experience long-lasting medical, psychological, and economic consequences.  Survivors with long covid are likely to have an increased need for health care and this could overwhelm health care systems, particularly in low- and middle-income countries. The authors of the study recommend that special treatment plans be developed to help care for those affected. 

“Since survivors may not have the energy or resources to go back and forth to their health care providers, one-stop clinics will be critical to effectively and efficiently manage patients with long COVID,” said Dr. Paddy Ssentongo, co-lead investigator and assistant professor at the Penn State Center for Neural Engineering. “Such clinics could reduce medical costs and optimize access to care, especially in populations with historically larger health care disparities.”

“The burden of poor health in COVID-19 survivors is overwhelming,” said Ssentongo. “Among these are the mental health disorders. One’s battle with COVID doesn’t end with recovery from the acute infection. Vaccination is our best ally to prevent getting sick from COVID-19 and to reduce the chance of long-COVID even in the presence of a breakthrough infection.”

The study is published in the journal JAMA Network Open.

By Alison Bosman, Staff Writer

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