Why; A new long-term study on Covid based on the experiences of nearly 100,000 participants provides strong evidence that many people do not fully recover months after contracting the coronavirus. The Scottish study found that between six and 18 months after infection, 1 in 20 people had not recovered and 42 percent reported a partial recovery. There were some reassuring aspects to the results: People with asymptomatic infections are unlikely to suffer long-term effects, and vaccination appears to offer some protection from long-term Covid. What you need to know about the latest on the long covid “It’s another well-conducted population-level study that shows we should be extremely concerned about the current numbers of acute infections,” said David Putrino, director of rehabilitation innovation for Mount Sinai Health System in New York. “We’re in trouble.” Jill Pell, a professor of public health at the University of Glasgow who led the research, said the study revealed the long-term impact of the coronavirus on people’s lives. “There are many different impacts beyond health on quality of life, employment, school and the ability to take care of yourself,” she said. For these three long-haul travelers, debilitating symptoms and fatigue prevented them from returning to work—and in turn, struggled to navigate their new normal. (Video: Drea Cornejo, Joy Yi, Colin Archdeacon/The Washington Post, Photo: Carolyn Van Houten/The Washington Post) How long Covid is accelerating a revolution in medical research The paper, published Wednesday in Nature Communications, represents the first findings of an ongoing long-term covid study – the Long-CISS (Covid in Scotland Study). The range of reported symptoms and the inability to provide a prognosis for patients have confounded researchers with long-term Covid, even as the scope of the challenge has become clearer. Between 7 and 23 million Americans — including 1 million who can no longer work — are suffering from the long-term effects of the virus infection, according to government estimates. These numbers are expected to increase as Covid becomes an endemic disease. Previous studies have been challenged by the non-specific nature of long-term Covid symptoms, including shortness of breath and fatigue, which are also common in the general population. The Covid in Scotland study, which included a control group, was able to identify which symptoms were linked to Covid, Pell said. “Those who had covid were significantly more likely to experience 24 of the 26 symptoms studied compared to the general population who had never been infected,” he said. For example, those infected were 3½ times more likely to have shortness of breath. He went to one doctor, then another, and another Putrino pointed out that between 16 and 31 percent of the control group also suffered the same symptoms—a number that is similar to the false-negative rate of a PCR test, suggesting that some of the control group may have been infected. Pell agreed that it is possible that some people with negative tests may have been infected, which reinforces the study’s broader findings. Symptoms of long-distance transfers vary widely from person to person. In the Scottish study, the most commonly reported symptoms included shortness of breath, palpitations, chest pain, and “brain fog,” or reduced mental acuity. Symptoms were worse among people who were sick enough to be hospitalized during the acute infection – which does little to quell experts’ concerns. “It’s always been the case that those who are sicker are more likely to have long-term consequences,” Putrino said. “What’s scary is that mild cases far outnumber severe cases, so even a small percentage of mild cases that develop long-term sequelae is a huge public health concern.” Putrino also cautioned against assuming that asymptomatic infection is not associated with persistent symptoms. “We have seen many patients who have had a confirmed asymptomatic case,” he said. “It does happen. It’s statistically less common than those with symptomatic infection.” The study found that the risk of long-term covid was greater among women, the elderly and those living in economically disadvantaged communities. People who already suffered from physical and mental health problems, such as respiratory illnesses and depression, were also more susceptible to long-term Covid. “Importantly, this study also identified an 11 percent subcohort that worsened over time. This is something that is often seen in patient groups, but has not been discussed enough in the public debate,” said Hannah Davis, a member of the Patient-Led Research Collaborative, a group of patients involved in long-term research into Covid. While the study revealed no particular surprises, its nationwide design provides new rigor, Pell said. More than 33,000 people with laboratory-confirmed infections participated, along with 62,957 people who had never been infected. Throughout the pandemic, US experts, including the president’s chief medical adviser Anthony S. Fauci, have regularly turned to British data because it comes from the nationalized health system and reflects trends in the entire population. The long-running coronavirus is destroying careers, leaving financial distress in its wake Using National Health Service records, the researchers sent a text message to every Scottish adult who had a positive PCR test as well as a group of people who tested negative for the coronavirus to invite them to participate. Those who chose to enroll answered online survey questions about their health before and after infection. “Being able to access research data from this large cohort is very powerful,” said James Harker, an immunologist at Imperial College London who studies the long-term effect of the coronavirus on the lungs. American studies have largely had to rely on smaller numbers or use enough studies to create meta-analyses, which have inherent flaws, Harker said. Among the issues that deserve more investigation is the degree of protection afforded by vaccination, according to Putrino. Recent studies show that vaccination reduces the chance of long-term coronavirus, but not as much as previously thought. “That’s one of the most important things to figure out going forward,” Putrino said. The University of Glasgow team led by Pell worked with Public Health Scotland, the National Health Service in Scotland and the Universities of Aberdeen and Edinburgh and was funded by the Scottish Chief Science Office and Public Health Scotland. Investigators additional studies are being planned, according to Pell. The current study followed people at six, 12 and 18 months after infection. Among those who had confirmed Covid, 13 percent reported some improvement. “We’re trying to look more closely at these changes in symptoms over time and the factors associated with them,” Pell said.
