Tag: long covid prevalence

Long COVID in general practice: an analysis of the equity of NHS England’s enhanced service specification

Introduction:

On 5 September 2021, 1.7% of the UK population reported suffering from prolonged symptoms 4 weeks after COVID-19 infection, the syndrome becoming known as long COVID,1 most commonly causing fatigue, headaches, and attention difficulties.2

Despite the vaccination programme, in the autumn of 2021 approximately 40 000 COVID-19 cases were still being recorded daily, of which an estimated 3.0–11.7% will subsequently develop long COVID.3,4 Therefore, long COVID will continue to be a problem into the future.

Deprived populations have a greater prevalence of diseases, which render them at greater risk of serious illness with COVID-19, as well as social factors that increase viral exposure such as dense housing or occupational exposure.5 Meanwhile, the inverse care law means these populations have more limited access to healthcare services, demonstrated in part by the lower numbers of GPs per patient in deprived populations,6,7

General practice is the first point of contact of the NHS for these patients. Therefore, the commissioning and funding of services in general practice for patients with long COVID needs to take account of these factors to prevent a continuation or exacerbation of the disproportionate COVID-19 impact on deprived populations.

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Source: Hutchinson J, Checkland K, Munford L, Khavandi S, Sutton M. Long COVID in general practice: an analysis of the equity of NHS England’s enhanced service specification. Br J Gen Pract. 2022 Jan 27;72(715):85-86. doi: 10.3399/bjgp22X718505. PMID: 35091414. https://bjgp.org/content/72/715/85.full (Full text)

Post-acute neurological consequences of COVID-19: an unequal burden

COVID-19 and its neurological consequences particularly burden marginalized communities, and so can only be effectively treated by advancing health equity.

Our world has witnessed over 275 million confirmed cases of COVID-19 and over 5 million related deaths1. Marginalized communities everywhere continue to be disproportionately affected as the pandemic amplifies longstanding health and healthcare disparities. As an example, in the United States, members of the Black, Indigenous and Latino communities remain two to three times more likely to be infected with SARS-CoV-2, to be hospitalized with COVID-19 and to die from this disease2. Dismantling structural racism is necessary to improve neurological health, as greater attention is focused on understanding and addressing the post-acute neurological consequences of COVID-19, or the neurological manifestations of what is sometimes called long COVID.

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Source: Nolen, L.T., Mukerji, S.S. & Mejia, N.I. Post-acute neurological consequences of COVID-19: an unequal burden. Nat Med 28, 20–23 (2022). https://doi.org/10.1038/s41591-021-01647-5  (Full text)

Prevalence, characteristics, and predictors of Long COVID among diagnosed cases of COVID-19

Abstract:

Background: Long COVID or long-term complication after COVID-19 has the ability to affect health and quality of life. Knowledge about the burden and predictors could aid in their prevention and management. Most of the studies are from high-income countries and focus on severe cases. We did this study to estimate the prevalence and identify the characteristics and predictors of Long COVID among our patients.

Methodology: We recruited adult (≥18 years) patients who were diagnosed as Reverse Transcription Polymerase Chain Reaction (RTPCR) confirmed SARS-COV-2 infection and were either hospitalized or tested on outpatient basis. Eligible participants were followed up telephonically after four weeks of diagnosis of SARS-COV-2 infection to collect data on sociodemographic, clinical history, vaccination history, Cycle threshold (Ct) values during diagnosis and other variables. Characteristics of Long COVID were elicited, and multivariable logistic regression was done to find the predictors of Long COVID.

Results: We have analyzed 487 individual data with a median follow-up of 44 days (Inter quartile range (IQR): 39,47). Overall, Long COVID was reported by 29.2% (95% Confidence interval (CI): 25.3%,33.4%) participants. Prevalence of Long COVID among patients with mild/moderate disease (n = 415) was 23.4% (95% CI: 19.5%,27.7%) as compared to 62.5% (95% CI: 50.7%,73%) in severe/critical cases(n=72). The most common Long COVID symptom was fatigue (64.8%) followed by cough (32.4%). Statistically significant predictors of Long COVID were – Pre-existing medical conditions (Adjusted Odds ratio (aOR)=2.00, 95% CI: 1.16,3.44), having a more significant number of symptoms during acute phase of COVID-19 disease (aOR=11.24, 95% CI: 4.00,31.51), two doses of COVID-19 vaccination (aOR=2.32, 95% CI: 1.17,4.58), the severity of illness (aOR=5.71, 95% CI: 3.00,10.89) and being admitted to hospital (Odds ratio (OR)=3.89, 95% CI: 2.49,6.08).

Conclusion: A considerable proportion of COVID-19 cases reported Long COVID symptoms. More research is needed in Long COVID to objectively assess the symptoms and find the biological and radiological markers.

Source: M. C. Arjun, Arvind Kumar Singh, Debkumar Pal, Kajal Das, Alekhya Gajjala, Mahalingam Venkateshan, Baijayantimala Mishra, Binod Kumar Patro, Prasanta Raghab Mohapatra, Sonu Hangma Subba. Prevalence, characteristics, and predictors of Long COVID among diagnosed cases of COVID-19. medRxiv 2022.01.04.21268536; doi: https://doi.org/10.1101/2022.01.04.21268536 https://www.medrxiv.org/content/10.1101/2022.01.04.21268536v1.full-text (Full text)