General

This is a new literature review updated on may 2022. In case some essential information is missing, please contact us at: rafael@hcuge.ch.

Patterns of Long COVID Symptoms: A Multi-Center Cross Sectional Study 

Yelin D, Margalit I, Nehme M, Bordas-Martínez J, Pistelli F, Yahav D, Guessous I, Durà-Miralles X, Carrozzi L, Shapira-Lichter I, Vetter P, Peleato-Catalan D, Tiseo G, Wirtheim E, Kaiser L, Gudiol C, Falcone M, Leibovici L, On Behalf Of The LongCOV Research Group. J Clin Med. 2022 Feb 9;11(4):898. doi: 10.3390/jcm11040898. PMID: 35207171.

Authors included 1027 symptomatic post-COVID individuals from four countries (Israel, Italy, Spain and Switzerland). The majority of participants were graded as having a non-severe acute COVID-19 (N = 763, 74.3%). Authors identified six patterns of symptoms: cognitive, pain-syndrome, pulmonary, cardiac, anosmia-dysgeusia and headache. The cognitive pattern was the major symptoms pattern, explaining 26.2% of the variance; the other patterns each explained 6.5-9.5% of the variance. The cognitive pattern was higher in patients who were outpatients during the acute disease. The pain-syndrome pattern was associated with acute disease severity, higher in women and increased with age. The pulmonary pattern was associated with prior lung disease and severe acute disease. Only two of the patterns (cognitive and cardiac) were associated with failure to return to pre-COVID occupational and physical activity status.  

Link to study : Patterns of Long COVID Symptoms: A Multi-Center Cross Sectional Study

Excess risk and clusters of symptoms after COVID-19 in a large Norwegian cohort 

Caspersen IH, Magnus P, Trogstad L. Eur J Epidemiol. 2022 Feb 25. doi: 10.1007/s10654-022-00847-8. Epub ahead of print. PMID: 35211871.

Authors aimed to calculate the excess risk and identify patterns of 22 symptoms up to 12 months after COVID-19, following more than 70,000 adult participants in an ongoing cohort study, the Norwegian Mother, Father and Child Cohort Study (MoBa) during the COVID-19 pandemic. One year after infection, 13 of 22 symptoms were associated with SARS-CoV-2 infection, based on relative risks between infected and uninfected subjects. For instance, 17.4% of SARS-CoV-2 infected cohort participants reported fatigue that persist 12 months after infection, compared to new occurrence of fatigue that had lasted less than 12 months in 3.8% of non-infected subjects (excess risk 13.6%). The adjusted relative risk for fatigue was 4.8 (95% CI 3.5–6.7). Two main underlying factors explained 50% of the variance in the 13 symptoms. Brain fog, poor memory, dizziness, heart palpitations, and fatigue had high loadings on the first factor, while shortness-of breath and cough had high loadings on the second factor. Lack of taste and smell showed low to moderate correlation to other symptoms. Anxiety, depression and mood swings were not strongly related to COVID-19. Results suggest that there are clusters of symptoms after COVID-19 due to different mechanisms and question whether it is meaningful to describe long COVID as one syndrome.

Link to study: Excess risk and clusters of symptoms after COVID-19 in a large Norwegian cohort

Post-COVID-19 illness trajectory in community patients: mostly reassuring results 

Berry C, Bayes HK. Eur Heart J. 2022 Feb 15:ehac057. doi: 10.1093/eurheartj/ehac057. Epub ahead of print. PMID: 35165717.

In this cross-sectional, controlled study, 443 individuals aged 45–74 years living in the metropolitan area of Hamburg were examined after a first polymerase chain reaction (PCR)-positive SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) test obtained between 1 March and 31 December 2020 at least 4 months (median 9.6 months) prior to study enrolment. Based on the protocol for that study, the investigators assessed pulmonary, cardiac, vascular, renal, and neurological status, as well as patient-reported outcome measures (PROMS) of health-related quality of life, anxiety, depression, and cognition. Their study is highly informative particularly in relation to community-based, non-hospitalized individuals. The investigators found in mostly non-hospitalized post-COVID-19 patients that there were no differences in PROMS compared with controls, nor were there associations between objective measures of disease and PROMS. The observed differences in organ function could mostly be considered not clinically significant, although some findings such as possible deep vein thrombosis are of concern. The results are likely to be reliable given the large samples of patients and controls and the rigorous methodology. Overall, the results are important. They should give reassurance that on the question of whether ‘any’ infection with COVID-19 might be expected to impact on health-related quality of life in the longer term, this appears not to be the case. 

Link to study : Post-COVID-19 illness trajectory in community patients: mostly reassuring results 

Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review 

Groff D, Sun A, Ssentongo AE, Ba DM, Parsons N, Poudel GR, Lekoubou A, Oh JS, Ericson JE, Ssentongo P, Chinchilli VM. JAMA Netw Open. 2021 Oct 1;4(10):e2128568. doi: 10.1001/jamanetworkopen.2021.28568. PMID: 34643720; PMCID: PMC8515212.

Short-term and long-term persistent postacute sequelae of COVID-19 (PASC) have not been systematically evaluated. The incidence and evolution of PASC are dependent on time from infection, organ systems and tissue affected, vaccination status, variant of the virus, and geographic region.

Link to study : Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review

Joint patient and clinician priority setting to identify 10 key research questions regarding the long-term sequelae of COVID-19 

Houchen-Wolloff L, Poinasamy K, Holmes K, Tarpey M, Hastie C, Raihani K, Rogers N, Smith N, Adams D, Burgess P, Clark J, Cranage C, Desai M, Geary N, Gill R, Mangwani J, Staunton L, Berry C, Bolton CE, Chalder T, Chalmers J, De Soyza A, Elneima O, Geddes J, Heller S, Ho LP, Jacob J, McAuley H, Parmar A, Quint JK, Raman B, Rowland M, Singapuri A, Singh SJ, Thomas D, Toshner MR, Wain LV, Horsley AR, Marks M, Brightling CE, Evans RA. Thorax. 2022 Mar 30:thoraxjnl-2021-218582. doi: 10.1136/thoraxjnl-2021-218582. Epub ahead of print. PMID: 35354642.

Given the large numbers of people infected and high rates of ongoing morbidity, research is clearly required to address the needs of adult survivors of COVID-19 living with ongoing symptoms (long COVID). To help direct resource and research efforts, Authors completed a research prioritisation process incorporating views from adults with ongoing symptoms of COVID-19, carers, clinicians and clinical researchers. The final top 10 research questions were agreed at an independently mediated workshop and included: identifying underlying mechanisms of long COVID, establishing diagnostic tools, understanding trajectory of recovery and evaluating the role of interventions both during the acute and persistent phases of the illness.

Link to study : Joint patient and clinician priority setting to identify 10 key research questions regarding the long-term sequelae of COVID-19