An interesting news item published in The Lancet Respiratory Medicine on January 20th 2022 by Priya Venkatesan looks at this issue.
The United Kingdom Government’s Office of National Statistics published in their latest report on January 6th 2022 the prevalence of long COVID in the United Kingdom from a representational study. There were about 1.266 million people living in the United Kingdom of which 95% had self-reported long COVID symptoms.
The diagnosis was defined as symptoms persisting for more than 4 weeks after the first confirmed or suspected COVID-19 infection.
Of these individuals 70%, that is 892,000, had confirmed or suspected COVID-19 at least 12 weeks previously.
Fatigue was the most common symptom reported, followed by loss of smell, shortness of breath, and difficulty concentrating.
There is still lack of clarity about the true prevalence of long COVID in adults and children following infection.
It has been suggested that individuals who tested positive for COVID-19 infection in the UK between April 2020 and August 2021 that there were 3%-12% with new or ongoing symptoms some 12 weeks after the initial infection including those people who are not symptomatic during the acute phase.
Part of the issue with assessing the prevalence of long COVID is an absence of consistent information on terminology, definitions and diagnosis of the condition.
NICE defines long COVID as the signs and symptoms that continue to develop after acute COVID-19 from four weeks onwards whereas the WHO uses the term post COVID-19 condition define as occurring in individuals three months from the onset of SARS-CoV-2 infection.
Additionally, a substantial proportion of patients might have persistent symptoms for one year or more after infection.
More than half a million individuals that is 40%, from the January 2022 ONS report described having long COVID had been infected at least one year previously.
However, the general consensus is that long COVID is the failure to return to normal, pre-COVID levels of health, and is surprisingly common.
More research is needed to gauge the full spectrum of symptoms of long COVID to facilitate diagnosis of the condition; as well as fatigue and shortness of breath, the NICE guideline lists many other commonly reported symptoms including:
- Palpitations
- Neurological symptoms such as dizziness
- Gastrointestinal symptoms including nausea and weight loss.
Research is needed to understand why after acute COVID-19 infection, the impact of the disease varies from patient to patient, from full recovery to severe persistent symptoms affecting multiple organs and mental health.
The data on long COVID is worrying, particularly during the current increase in global cases of COVID-19 infection.
There are, however, encouraging emerging data that individuals who are vaccinated against COVID-19 are less likely to report long COVID symptoms.
For example, a case-control study of 1.2 million users of a COVID symptom tracker app in the UK showed that there were lower odds of symptoms lasting 28 days or more in individuals who had received two vaccine doses.
The risk of developing long COVID was reduced by around 50% in those who were double vaccinated.
The reasons for vaccination beyond the most pressing need to avert severe disease and deaths are manifold but foremost it is to prevent long COVID.
As Dr De Soyza from the National Institute of Health Research Newcastle Biomedical Research Centre University of Newcastle added (ideally preventing both acute severe COVID through vaccination and also reducing the chances of long COVID represents an additional driver to support people to get vaccinated).
The London General Practice the leading London Doctors’ clinic in Harley Street commends the National Health Service on its vaccination program and encourages all those eligible to have vaccination and also have their boosters.
The London General Practice offers a long COVID support clinic using a multidisciplinary team to help all those suffering to gain the very best advice available.
Dr Paul Ettlinger
BM, DRCOG, FRCGP, FRIPH, DOccMed