Tag: long covid symptoms

Post COVID fatigue: Can we really ignore it?

Abstract:

Long-COVID, also referred to as post-acute COVID-19, chronic COVID-19, post-COVID syndrome, or post-acute sequelae of SARS-CoV-2 infection (PASC), generally refers to symptoms that develop during or after acute COVID-19 illness, continue for ≥12 weeks, and are not explained by an alternative diagnosis. It is not yet known whether “long-COVID” represents a new syndrome unique to COVID-19 or overlaps with recovery from similar illnesses. It’s difficult for physicians to predict when symptoms will improve as it varies differently in different people. Patient’s recovery depends on various factors including age, associated comorbidities, severity of COVID-19 infection. Some symptoms, like fatigue, might continue even while others improve or go away. This review addresses the pathogenesis, presentation of post covid fatigue, its severity and its management.

Source: Sharma P, Bharti S, Garg I. Post COVID fatigue: Can we really ignore it? Indian J Tuberc. 2022 Apr;69(2):238-241. doi: 10.1016/j.ijtb.2021.06.012. Epub 2021 Jun 23. PMID: 35379408. https://pubmed.ncbi.nlm.nih.gov/35379408/

Sulodexide: A Benefit for Cardiovascular Sequelae of Long COVID Patients?

Dear Editor,

The elaborate and precise review of Harry N. Magnani didactically demonstrates the complex pathophysiological aspects of coronavirus disease 2019 (COVID-19) emphasizing the roles of vascular endothelial dysfunction and coagulation cascade as key features of disease progression.  Moreover, this article brings up that glycosaminoglycane (GAG) antithrombotics likely interfere with inflammatory and coagulation activity in an effective fashion.  Thereafter this postulate has become advocated as the application of sulodexide (Vessel Due F; ALFASIGMA, Italy) (SDX), an unexpensive and orally administrable GAG antithrombotic drug reduced the necessity for both hospital admission and oxygen supplementation in the early phase of SARS-Cov-2 infection under a randomized placebo-controlled out-patient trial.  Interestingly, these patients also showed lower serum levels of C-reactive protein (CRP) and D-dimer as markers of inflammation and prothrombotic state. Of note, instead of regularly recommended and prescribed 250 RLU twice-daily dose, the clinical trial applied the higher, 500 RLU twice-daily dosing regimen in which an antithrombotic effect was safely achieved in a clinical setting.

Read the rest of this article HERE.

Source: Szolnoky G, González-Ochoa AJ. Sulodexide: A Benefit for Cardiovascular Sequelae of Long COVID Patients? Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221084300. doi: 10.1177/10760296221084300. PMID: 35333125; PMCID: PMC8961374. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8961374/ (Full text)

Sex-Related Differences in Long-COVID-19 Syndrome

Abstract:

Background: Sex differences have been demonstrated in the acute phase of COVID-19. Women (F) were found to be less prone to develop a severe disease than men (M), but few studies have assessed sex-differences in Long-COVID-19 syndrome.

Methods: The aim of this prospective/retrospective study was to characterize the long-term consequences of this infection based on sex. For this purpose, we enrolled 223 patients (89 F and 134 M) who were infected by SARS-CoV-2. In the acute phase of the illness, F reported the following symptoms more frequently than M: weakness, dysgeusia, anosmia, thoracic pain, palpitations, diarrhea, and myalgia-all without significant differences in breathlessness, cough, and sleep disturbance.

Results: After a mean follow-up time of 5 months after the acute phase, F were significantly more likely than M to report dyspnea, weakness, thoracic pain, palpitations, and sleep disturbance but not myalgia and cough. At the multivariate logistic regression, women were statistically significantly likely to experience persistent symptoms such as dyspnea, fatigue, chest pain, and palpitations. On the contrary, myalgia, cough, and sleep disturbance were not influenced by sex.

Conclusion: We demonstrated that F were more symptomatic than M not only in the acute phase but also at follow-up. Sex was found to be an important determinant of Long-COVID-19 syndrome because it is a significant predictor of persistent symptoms in F, such as dyspnea, fatigue, chest pain, and palpitations. Our results suggest the need for long-term follow-up of these patients from a sex perspective to implement early preventive and personalized therapeutic strategies.

Source: Pelà G, Goldoni M, Solinas E, Cavalli C, Tagliaferri S, Ranzieri S, Frizzelli A, Marchi L, Mori PA, Majori M, Aiello M, Corradi M, Chetta A. Sex-Related Differences in Long-COVID-19 Syndrome. J Womens Health (Larchmt). 2022 Mar 25. doi: 10.1089/jwh.2021.0411. Epub ahead of print. PMID: 35333613. https://www.liebertpub.com/doi/10.1089/jwh.2021.0411 (Full text)

Efficacy of Adaptogens in Patients with Long COVID-19: A Randomized, Quadruple-Blind, Placebo-Controlled Trial

Abstract:

Currently, no effective treatment of comorbid complications or COVID-19 long-haulers during convalescence is known. This randomized, quadruple-blind, placebo-controlled trial aimed to assess the efficacy of adaptogens on the recovery of patients with Long COVID symptoms. One hundred patients with confirmed positive SARS-CoV-2 test, discharged from COVID Hotel isolation, Intensive Care Unit (ICU), or Online Clinics, and who experienced at least three of nine Long COVID symptoms (fatigue, headache, respiratory insufficiency, cognitive performance, mood disorders, loss of smell, taste, and hair, sweatiness, cough, pain in joints, muscles, and chest) in the 30 days before randomization were included in the study of the efficacy of Chisan®/ADAPT-232 (a fixed combination of adaptogens Rhodiola, Eleutherococcus, and Schisandra) supplementation for two weeks.

Chisan® decreased the duration of fatigue and pain for one and two days, respectively, in 50% of patients. The number of patients with lack of fatigue and pain symptoms was significantly less in the Chisan® treatment group than in the placebo group on Days 9 (39% vs. 57%, pain relief, p = 0.0019) and 11 (28% vs. 43%, relief of fatigue, * p = 0.0157). Significant relief of severity of all Long COVID symptoms over the time of treatment and the follow-up period was observed in both groups of patients, notably decreasing the level of anxiety and depression from mild and moderate to normal, as well as increasing cognitive performance in patients in the d2 test for attention and increasing their physical activity and workout (daily walk time).

However, the significant difference between placebo and Chisan® treatment was observed only with a workout (daily walk time) and relieving respiratory insufficiency (cough). A clinical assessment of blood markers of the inflammatory response (C-reactive protein) and blood coagulation (D-dimer) did not reveal any significant difference over time between treatment groups except significantly lower IL-6 in the Chisan® treatment group. Furthermore, a significant difference between the placebo and Chisan® treatment was observed for creatinine: Chisan® significantly decreased blood creatinine compared to the placebo, suggesting prevention of renal failure progression in Long COVID. In this study, we, for the first time, demonstrate that adaptogens can increase physical performance in Long COVID and reduce the duration of fatigue and chronic pain. It also suggests that Chisan®/ADAPT-232 might be useful for preventing the progression of renal failure associated with increasing creatinine.

Source: Karosanidze I, Kiladze U, Kirtadze N, Giorgadze M, Amashukeli N, Parulava N, Iluridze N, Kikabidze N, Gudavadze N, Gelashvili L, Koberidze V, Gigashvili E, Jajanidze N, Latsabidze N, Mamageishvili N, Shengelia R, Hovhannisyan A, Panossian A. Efficacy of Adaptogens in Patients with Long COVID-19: A Randomized, Quadruple-Blind, Placebo-Controlled Trial. Pharmaceuticals (Basel). 2022 Mar 11;15(3):345. doi: 10.3390/ph15030345. PMID: 35337143; PMCID: PMC8953947. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8953947/ (Full text)

What Are the Long-term Pulmonary Sequelae of COVID-19 Infection?

The COVID-19 pandemic has been ongoing for almost two years. Over this period, Radiology and other peer-reviewed journals have distributed information regarding the nature of the pandemic with unprecedented speed. Based upon the extensively documented clinical and imaging manifestations of acute COVID-19 infection, expert thoracic imagers have developed imaging categories that classify patterns according to the likelihood that they represent COVID-19 infection(1).

Acute COVID-19 has a somewhat unique appearance amongst viral infections on CT. It manifests as ground-glass opacities and/or consolidation often with a strong peripheral distribution. Also, there are CT findings suggesting that organizing pneumonia is a common pattern of injury. Organizing pneumonia is associated with a wide variety of different infections, however, it appears particularly common with COVID-19(2). However, the long-term pulmonary manifestations of COVID-19 pneumonia (part of so-called “long-COVID”) remain lacking in the literature.

It is important to understand our current knowledge of viral infections and their typical manifestations within the lungs. The long-term sequela of viral pneumonia, in general, vary depending upon two factors: 1) direct injury caused by the viral organisms, and 2) the host’s immune reaction to those organisms. These result in a variety of different patterns of injury, each of which is associated with specific permanent long-term sequela. The histologic manifestations of acute pulmonary viral infections can be divided broadly into two primary patterns: 1) bronchiolitis and inflammation adjacent to airways, and 2) diffuse alveolar damage. On imaging, bronchiolitis and airway inflammation manifest as bronchial wall thickening, centrilobular nodules, and tree-in-bud opacities; whereas diffuse alveolar damage manifests as bilateral ground-glass opacity and/or consolidation.

The long-term effects of these two patterns are also characteristic. Inflammation within and around the airways may induce concentric fibrosis around the bronchioles resulting in airway narrowing or obliteration. This is termed constrictive (or obliterative) bronchiolitis. Development of constrictive bronchiolitis may result in persistent dyspnea after resolution of the acute infection with an associated obstructive defect on pulmonary function tests. Typical CT findings of constrictive bronchiolitis include mosaic attenuation and air trapping, sometimes associated with bronchiectasis. The long-term manifestations of diffuse alveolar damage (DAD), on the other hand, are quite different. Histologically, fibrosis develops 1-2 weeks after the development of acute symptoms. On imaging, this is associated with the development of reticulation and traction bronchiectasis. Over time, usually months, this fibrosis may improve, although residual fibrosis is common(3). This residual fibrosis is often located in the anterior subpleural lung and may be associated with restrictive physiology on pulmonary function testing.

Organizing pneumonia (OP) is particularly common with COVID-19. The clinical and imaging features of OP have been studied (4) mainly in the setting of cryptogenic (idiopathic) disease. Organizing pneumonia is usually a highly steroid-responsive disease with opacities that quickly improve or resolve with treatment, although residual fibrosis may occur. This residual fibrosis often has a pattern that resembles nonspecific interstitial pneumonia with basilar predominant reticulation, traction bronchiectasis, and subpleural sparing(5). It is also important to note that OP and DAD may co-exist with overlapping imaging findings.

Understanding the different patterns of injury associated with viral infections and their long-term sequela is important in putting the long-term effects of COVID-19 infection in context. Han et al(6). were among the first to describe the persistent CT findings of COVID-19 six months after the onset of acute symptoms. In their study, over one-third of patients showed evidence of fibrotic changes.

In this issue of Radiology, Cho and Villacreses and colleagues (7) address these long-term pulmonary manifestations in a prospective study of 100 patients with persistent (>30 days) pulmonary symptoms after an acute COVID-19 infection. One hundred and six healthy controls were also evaluated. The particular emphasis of this investigation was on the presence of air trapping on expiratory CT. The severity of disease among studied patients varied and included outpatients, hospitalized patients, and those requiring admission to the intensive care unit (ICU). Cho and Villacreses et al. discovered that air trapping was present in 58% of patients with post-COVID-19 and had its highest prevalence in the group of patients hospitalized for their infection (73%). Using quantitative analysis, air trapping affected a mean of 25-35% of the lungs in patients with post-COVID-19 depending on the clinical severity of disease compared to 7% in controls (p<.001). The authors did not identify obstructive airways disease on spirometry in any of the groups. This lack of obstruction on spirometry in patients with air trapping is not surprising. In a cohort of soldiers deployed to Iraq and Afghanistan with biopsy-proven constrictive bronchiolitis(8), the majority did not have obstruction on pulmonary function tests. Restriction was present on spirometry in the patients with COVID-19 in the study by Cho and Villacreses et al., specifically in the inpatient and ICU groups. Ground-glass opacity, traction bronchiectasis, and other signs of fibrosis were most frequent in patients admitted to the ICU (94%, 69%, 81% of patients, respectively compared with 36%, 8%, and 3% of outpatients, respectively).

In summary, the study by Cho and Villacreses et al. demonstrates that air trapping on CT is common in patients with persistent symptoms after COVID-19 infection. When considering the long-term pulmonary effects of COVID-19 infection, this is an important finding and may correspond to the development of post-viral constrictive bronchiolitis, an entity seen with other viral infections and in particular, adenovirus infection. Interestingly, the CT findings of acute COVID-19 are not highly airway-centric. Centrilobular nodules and tree-in-bud opacities, reflecting airway-centric inflammation, are not a typical finding of acute COVID-19 infection. Regardless, these results indicate a long-term impact on bronchiolar obstruction. In the study by Cho and Villacreses et al, the presence of ground glass opacity and/or fibrosis on CT were most common in the patients admitted to the ICU and likely correspond to post-OP and/or post-DAD fibrosis.

It is important to note that not all pulmonary fibrosis, including that of the airway and of the parenchyma, is permanent. Collagen may be absorbed for months after the acute insult, thus it is not entirely clear if the abnormalities seen in the current study will be permanent. The median time from COVID-19 diagnosis to the clinic visit for persistent post-COVID-19 symptoms was only 75 days. However, 8 of 9 patients (out of 100 patients total) with imaging more than 200 days from the acute infection had persistent air trapping. Regardless of the imaging findings, the most important question is whether the airway obstruction and/or fibrosis result in clinical symptoms. This paper suggests that airways obstruction and post-OP/DAD fibrosis contribute to persistent symptoms after COVID-19 infection with the contribution of airways disease higher in the outpatients, and the contribution of OP/DAD greater in the patients admitted to ICU. Longer-term studies assessing the clinical and imaging manifestations 1-2 years after the initial infection are needed to fully ascertain the permanent manifestations of post-COVID fibrosis.

Source: Brett M. Elicker. What Are the Long-term Pulmonary Sequelae of COVID-19 Infection? Radiology. Published Online: Mar 15 2022. https://pubs.rsna.org/doi/10.1148/radiol.220449 (Full text)

Analysis of post COVID-19 condition and its overlap with myalgic encephalomyelitis/chronic fatigue syndrome

Abstract:

Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) disease (COVID-19) triggers the development of numerous pathologies and infection-linked complications and exacerbates existing pathologies in nearly all body systems. Aside from the primarily targeted respiratory organs, adverse SARS-CoV-2 effects were observed in nervous, cardiovascular, gastrointestinal/metabolic, immune, and other systems in COVID-19 survivors. Long-term effects of this viral infection have been recently observed and represent distressing sequelae recognised by the World Health Organisation (WHO) as a distinct clinical entity defined as post-COVID-19 condition. Considering the pandemic is still ongoing, more time is required to confirm post COVID-19 condition diagnosis in the COVID-19 infected cohorts, although many reported post COVID-19 symptoms overlap with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Aims of Review: In this study, COVID-19 clinical presentation and associated post-infection sequelae (post-COVID-19 condition) were reviewed and compared with ME/CFS symptomatology.

Key Scientific Concepts of Review: The onset, progression, and symptom profile of post COVID-19 condition patients have considerable overlap with ME/CFS. Considering the large scope and range of pro-inflammatory effects of this virus, it is reasonable to expect development of post COVID-19 clinical complications in a proportion of the affected population. There are reports of a later debilitating syndrome onset three months post COVID-19 infection (often described as long-COVID-19), marked by the presence of fatigue, headache, cognitive dysfunction, post-exertional malaise, orthostatic intolerance, and dyspnoea. Acute inflammation, oxidative stress, and increased levels of interleukin-6 (IL-6) and tumor necrosis factor α (TNFα), have been reported in SARS-CoV-2 infected patients. Longitudinal monitoring of post COVID-19 patients is warranted to understand the long-term effects of SARS-CoV-2 infection and the pathomechanism of post COVID-19 condition.

Source: Sukocheva OA, Maksoud R, Beeraka NM, Madhunapantula SV, Sinelnikov M, Nikolenko VN, …. and Marshall-Gradisnik S. Analysis of post COVID-19 condition and its overlap with myalgic encephalomyelitis/chronic fatigue syndrome.  Journal of Advanced Research, Available online 26 November 2021. https://www.sciencedirect.com/science/article/pii/S2090123221002320  (Full text)

Neurocognitive and psychiatric post-coronavirus disease 2019 conditions: pathogenic insights of brain dysfunction following severe acute respiratory syndrome coronavirus 2 infection

Abstract:

Purpose of review: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of coronavirus disease 2019 (COVID-19), can trigger a myriad of neuropsychiatric manifestations. As a 2-year-old disease (at the writing of this manuscript), its long-term cognitive and neuropsychiatric implications, known as post-COVID-19 conditions, are incompletely recognized and mechanistically obscure.

Recent findings: Fatigue, anxiety, depression, posttraumatic stress disorder, and cognitive dysfunction are reported more frequently in COVID-19 survivors than in matching, non-COVID-19 population. Risk factors are unclear, including comorbidities, age at COVID-19 onset, or disease severity; women, however, have been reported to be at increased risk than men. Although the frequency of these symptoms decreases over time, at least one in five will have persistent cognitive and neuropsychiatric manifestations one year after recovering from COVID-19.

Summary: Neurocognitive and psychiatric post-COVID-19 long-term conditions are frequent and complex multifactorial sequelae. Several acute and chronic factors such as hypoxemia, cerebral thrombotic and inflammatory endothelial damage, and disruption of the blood-brain barrier (leading to parenchymal translocation of pro-inflammatory molecules, cytokines, and cytotoxic T lymphocytes) are involved, leading to microglial activation and astrogliosis. As an evolving topic, evidence derived from prospective studies will expand our understanding of post-COVID-19 these long-term outcomes.

Source: García-Grimshaw M, Sankowski R, Valdés-Ferrer SI. Neurocognitive and psychiatric post-coronavirus disease 2019 conditions: pathogenic insights of brain dysfunction following severe acute respiratory syndrome coronavirus 2 infection. Curr Opin Neurol. 2022 Mar 11. doi: 10.1097/WCO.0000000000001046. Epub ahead of print. PMID: 35283463. https://pubmed.ncbi.nlm.nih.gov/35283463/

On the single and multiple associations of COVID-19 post-acute sequelae: 6-month prospective cohort study

Abstract:

Medical research is progressing to clarify the full spectrum of sub-acute and long-term effects of the post-COVID-19 syndrome. However, most manuscripts published to date only analyze the effects of post-COVID-19 in patients discharged from hospital, which may induce significant bias. Here, we propose a pioneering study to analyze the single and multiple associations between post-COVID-19 characteristics with up to 6-months of follow-up in hospitalized and non-hospitalized COVID-19 patients. The cohort study was conducted from May to October 2020 at the University Hospital Virgen de la Nieves, the leading hospital assigned for patients with COVID-19 in Granada, Spain.

A total of 372 and 217 patients-with 217 and 207 included in the first and second follow-up visits-were referred 2 and 6 months after diagnosing COVID-19, respectively. We find out that post-COVID-19 clinical and mental health impairment symptoms are correlated with patient gender. Logistic adjustments showed strong statistically robust single and multiple associations of demographic, clinical, mental health, X-ray, laboratory indices, and pulmonary function variables. The functional lung tests are good predictors of chest CT imaging abnormalities in elderly patients. Bilateral lung involvement, subpleural reticulum, ground-glass opacity, peripheral lung lesions, and bronchiectasis were the most common findings of the high-resolution computed tomography images. Non-hospitalized patients suffer more severe thromboembolic events and fatigue than those hospitalized.

Source: Jiménez-Rodríguez BM, Gutiérrez-Fernández J, Ramos-Urbina EM, Romero-Ortiz AD, García-Flores PI, Santiago-Puertas MI, Martín-López MJ, López-Milena G, Fabregas R, Morales-García C. On the single and multiple associations of COVID-19 post-acute sequelae: 6-month prospective cohort study. Sci Rep. 2022 Mar 1;12(1):3402. doi: 10.1038/s41598-022-07433-8. PMID: 35233062; PMCID: PMC8888754. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888754/ (Full text)

Serial Changes of Long COVID Symptoms and Clinical Utility of Serum Antibody Titers for Evaluation of Long COVID

Abstract:

Background: Various symptoms persist even after the acute symptoms in about one third of patients with COVID-19. In February 2021, we established an outpatient clinic in a university hospital for patients with long COVID and started medical treatment for sequelae that persisted one month or more after infection.

Methods: To determine the key factors that affect the onset and clinical course of sequelae, a retrospective analysis was performed at Okayama University Hospital (Japan) between February and July 2021. We focused on changes in the numbers of symptoms and the background of the patients during a three-month period from the first outpatient visit. We also examined the relationship with SARS-CoV-2 antibody titers.

Results: Information was obtained from medical records for 65 patients. The symptoms of sequelae were diverse, with more than 20 types. The most frequent symptoms were general malaise, dysosmia, dysgeusia, sleeplessness, and headache. These symptoms improved in about 60% of the patients after 3 months. Patients who required hospitalization and had a poor condition in the acute phase and patients who received oxygen/dexamethasone therapy had higher antibody titers at the time of consultation. Patients with antibody titers ≥200 U/mL showed significantly fewer improvements in long COVID symptoms in 1 month, but they showed improvements at 3 months after the first visit.

Conclusion: Long COVID symptoms were improved at 3 months after the initial visit in more than half of the patients. Serum antibody titers were higher in patients who experienced a severe acute phase, but the serum antibody titers did not seem to be directly related to the long-term persistence of long COVID symptoms.

Source: Sakurada Y, Sunada N, Honda H, Tokumasu K, Otsuka Y, Nakano Y, Hanayama Y, Furukawa M, Hagiya H, Otsuka F. Serial Changes of Long COVID Symptoms and Clinical Utility of Serum Antibody Titers for Evaluation of Long COVID. J Clin Med. 2022 Feb 27;11(5):1309. doi: 10.3390/jcm11051309. PMID: 35268400; PMCID: PMC8911256.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911256/ (Full text)

Characteristics and impact of Long Covid: Findings from an online survey

Abstract:

Background: Long Covid is a public health concern that needs defining, quantifying, and describing. We aimed to explore the initial and ongoing symptoms of Long Covid following SARS-CoV-2 infection and describe its impact on daily life.

Methods: We collected self-reported data through an online survey using convenience non-probability sampling. The survey enrolled adults who reported lab-confirmed (PCR or antibody) or suspected COVID-19 who were not hospitalised in the first two weeks of illness. This analysis was restricted to those with self-reported Long Covid. Univariate comparisons between those with and without confirmed COVID-19 infection were carried out and agglomerative hierarchical clustering was used to identify specific symptom clusters, and their demographic and functional correlates.

Results: We analysed data from 2550 participants with a median duration of illness of 7.6 months (interquartile range (IQR) 7.1-7.9). 26.5% reported lab-confirmation of infection. The mean age was 46.5 years (standard deviation 11 years) with 82.8% females and 79.9% of participants based in the UK. 89.5% described their health as good, very good or excellent before COVID-19. The most common initial symptoms that persisted were exhaustion, chest pressure/tightness, shortness of breath and headache. Cognitive dysfunction and palpitations became more prevalent later in the illness. Most participants described fluctuating (57.7%) or relapsing symptoms (17.6%). Physical activity, stress, and sleep disturbance commonly triggered symptoms. A third (32%) reported they were unable to live alone without any assistance at six weeks from start of illness. 16.9% reported being unable to work solely due to COVID-19 illness. 37.0% reported loss of income due to illness, and 64.4% said they were unable to perform usual activities/duties. Acute systems clustered broadly into two groups: a majority cluster (n = 2235, 88%) with cardiopulmonary predominant symptoms, and a minority cluster (n = 305, 12%) with multisystem symptoms. Similarly, ongoing symptoms broadly clustered in two groups; a majority cluster (n = 2243, 88.8%) exhibiting mainly cardiopulmonary, cognitive symptoms and exhaustion, and a minority cluster (n = 283, 11.2%) exhibiting more multisystem symptoms. Belonging to the more severe multisystem cluster was associated with more severe functional impact, lower income, younger age, being female, worse baseline health, and inadequate rest in the first two weeks of the illness, with no major differences in the cluster patterns when restricting analysis to the lab-confirmed subgroup.

Conclusion: This is an exploratory survey of Long Covid characteristics. Whilst this is a non-representative population sample, it highlights the heterogeneity of persistent symptoms, and the significant functional impact of prolonged illness following confirmed or suspected SARS-CoV-2 infection. To study prevalence, predictors and prognosis, research is needed in a representative population sample using standardised case definitions.

Source: Ziauddeen N, Gurdasani D, O’Hara ME, Hastie C, Roderick P, Yao G, Alwan NA. Characteristics and impact of Long Covid: Findings from an online survey. PLoS One. 2022 Mar 8;17(3):e0264331. doi: 10.1371/journal.pone.0264331. PMID: 35259179; PMCID: PMC8903286. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8903286/ (Full text)