What are the 3 main types of prolonged COVID?

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Long-term COVID patients may experience different types and severities of persistent symptoms. Allison Shelley/For The Washington Post via Getty Images
  • A new study seeks to advance understanding of the long COVID.
  • It finds that prolonged COVID can be divided into three types of conditions, based on the type of symptoms experienced.
  • The study authors also find links between COVID-19 variants, symptoms, and prolonged duration of COVID.

As experts try to unravel the tangle of symptoms and long-term effects of what is collectively known as “long-term COVID,” a new study seeks to provide some clarity.

Work with data collected in a health study app by a personalized nutrition company ZOEResearchers at King’s College London in the UK have begun to discern some order out of chaos.

The study finds that prolonged COVID can be grouped into three types of symptom clusters: neurological symptoms, respiratory symptoms, and systemic/inflammatory and abdominal symptoms.

  • Neurological symptoms, the most frequently reported prolonged symptoms of COVID, include anosmia/dysosmia, brain fog, headache, delirium, depression and fatigue. (Loss of taste from COVID is usually attributed to loss of smell.)
  • Respiratory symptoms involve possible damage to the lungs and include severe shortness of breath, palpitations, fatigue, and chest pain.
  • Systemic/inflammatory and abdominal symptoms include musculoskeletal pain, anemia, myalgiasgastrointestinal disorders, malaise and fatigue.

For the study, the researchers analyzed data from 336,652 people collected by the ZOE COVID Symptoms Study. Of this group, 1,459 reported post-COVID symptoms defined as more than 12 weeks after acute COVID-19 infection.

dr jai marathe of the Boston University School of Medicine in Massachusetts, who was not involved in the study, said Today’s medical news“This study definitely improves our understanding of the post-COVID syndrome and, more importantly, who might be at risk for prolonged illness and frailty.”

“Physicians and patients,” Dr. Marathe noted, “are both looking for answers about who is at risk of developing long-term COVID, how long symptoms will last, what will help symptoms resolve, etc. While this study doesn’t answer all of these questions, it provides a solid framework on which to build.

The study, which has not yet been peer-reviewed, has been published on the preprint server. medRXiV.

The researchers were also able to begin to identify clusters of symptoms associated with SARS-CoV-2 variants and with vaccines.

Dr. Liane S. CañasCorresponding author of the study and postdoctoral research associate at King’s College London, said Today’s medical news:

“Our results suggest that chest-related symptoms (respiratory cluster) in the UK population were more evident among unvaccinated patients infected with the early form of the virus. [referred to as the “wild” variant].”

“In contrast,” continued Dr. Canas, “patients with the Alpha or Delta variants have shown a higher incidence of neurological symptoms, such as anosmia and mental confusion.”

“Unfortunately, we were unable to robustly assess the effect of vaccination for these two variants. For Alpha, we did not have enough people vaccinated at the time of infection. For Delta, we didn’t have enough unvaccinated people at the time of infection who went on to develop prolonged COVID,” she noted.

Systemic/inflammatory and abdominal conditions were slightly associated with all variants.

“On average,” said Dr Cañas, “the wild form of the virus has shown a longer prevalence of symptoms, 30 weeks compared to Delta and Alpha at 24 and 25 weeks respectively.”

“However,” he noted, “because we only looked at data from people with illnesses for more than 12 weeks, these results are less significant than the cluster profile and would require further research, which would also consider the effect of vaccination. ”

“The study findings,” Dr. Marathe said, “suggest that people struggling with prolonged COVID, experiencing severe shortness of breath, hoarse voice, loss of smell, fatigue, delirium, anosmia, headache, and fever have more likely to [experience] prolonged and severe symptoms.

“Physicians armed with this information,” he said, “can better advise their patients and expectations for symptom improvement. They can also work towards specific treatment approaches that address the cluster of symptoms they impact and hopefully improve clinical care for patients.”

The study authors are still analyzing data related to the Omicron variants, but have shared some preliminary thoughts.

Dr Canas said: “Initial results have shown that the prevalence of prolonged COVID among patients infected with the Omicron variant is much lower than that of the other variants.”

An article on the ZOE investigation says the chances of contracting prolonged COVID with Omicron were 20% to 50% lower than with other variants, and Omicron cases represented only 4.4% of cases studied, compared to 10, 8% of cases of the Delta variant.

Dr. Marathe cited other research on the relationship between Omicron variants and prolonged COVID:

“Some studies have reported a lower risk of developing prolonged COVID after COVID-19 infection with the Omicron variant compared to the Delta variant, while others have noted that patients who develop prolonged COVID after infection with the variant Omicron have a less severe illness. This is also true for the general decrease in symptom severity during acute Omicron infection.”

Although a lower percentage of people with COVID-19 infections from the Omicron variants develop long-term COVID, the higher infectivity of the strains means that more people become infected and therefore more people develop long-term COVID.

“While the total number of long-term COVID patients in the community may be lower, at Boston Medical Center, the number of patients seeking care at the long-term COVID clinic has remained consistent during post-Delta surges and Omicron,” said Dr. Marathé.

In terms of prolonged COVID symptoms with recent variants, not much has changed, he said:

“We have not noticed a big difference in prolonged COVID symptoms between the Omicron variants that were circulating during the winter and spring months. Fatigue, shortness of breath, mood disorders, and mental confusion remained the most common complaints reported by patients with prolonged COVID.”

Dr. Marathe found the new study valuable:

“This may pave the way for additional research efforts to assess the different pathobiological pathways that may contribute to the development of prolonged COVID and help us define the condition more successfully.”

“I think we still don’t know who is at risk of developing prolonged COVID and why they are at risk. As we increase our understanding of this disease, it will help inform strategies regarding the treatment and prevention of prolonged COVID,” she added.

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