Trending Clinical Topic: Long COVID

Ryan Syrek


September 04, 2020

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Concern and insights into the potential long-term effects of COVID-19 resulted in this week's top trending clinical topic. Persistent symptoms in some individuals with COVID-19 have resulted in new research into mechanisms that may underlie myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as well as other chronic postviral illnesses (see Infographic below).

The opening session of the virtual meeting of the International Association for CFS/ME (IACFS/ME) on August 21 was devoted to research regarding the extent to which some COVID-19 survivors meet ME/CFS criteria. This included a discussion of how previous research had drawn a potential link between a coronavirus and ME/CFS in the wake of the SARS-CoV-1 outbreak in 2003. A study found that 22 healthcare workers who had been infected reported chronic fatigue, musculoskeletal pain, and sleep disturbances as long as 3 years after the illness, with none returning to work within 1 year. Several ongoing studies are further exploring the possible connection between ME/CFS by working with "long COVID" communities such as Body Politic.

According to a report from the Centers for Disease Control and Prevention, more than a third of individuals who have tested positive for COVID-19 still have symptoms weeks later. The survey of nearly 300 adults found that about 35% said they were not back to their "usual state of health" 2-3 weeks after testing. Among those aged 18-34 years without underlying medical conditions, 1 in 5 said they hadn't completely recovered. Those who have had months-long issues have been called "COVID long-haulers."

A research letter from Italy published in the Journal of the American Medical Association reported that 87.4% of 143 previously hospitalized patients had at least one persistent symptom 2 months or more after initial onset and at more than a month after discharge. Nearly a third of the patients had one or two symptoms, while 55% had three or more. More than half (53.1%) still had fatigue.

A British study found that 81 out of 110 discharged patients who had been diagnosed with COVID-19 were still experiencing breathlessness, excessive fatigue, and muscle aches 3 months later. Although most patients reported improvements in initial symptoms such as fever, cough, and sense of smell, a large number still had significant quality-of-life issues. The findings are part of the hospital's DISCOVER project, the first of its kind to assess the longer-term effects of coronavirus.

Although the immediate effects of SARS-CoV-2 infection remain a primary concern in many areas, long COVID is an area of increasing focus. As is evident by this week's top trending clinical topic, research findings and detailed information are likely to be met with much interest.

Read more about ME/CFS.


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