One in eight adults infected with the coronavirus has long term symptoms due to Covid-19. The data are from a large Dutch study published in the scientific journal “The Lancet” this Thursday (4).
The analysis points to one of the first comparisons of long-term symptoms after infection, often referred to as “long covid “, with symptoms in an uninfected population, as well as measuring disease impacts on individuals before and after infection.
According to experts, the inclusion of uninfected populations allows for a more accurate prediction of the long-term prevalence of Covid-19 symptoms, as well as a better identification of the main related symptoms.
“There is an urgent need for data that inform the scale and scope of the long-term symptoms experienced by some patients after Covid-19,” says researcher Judith Rosmalen from the University of Groningen in the Netherlands, lead author of the study.
The expert explains that the approach used in the study analyzes the symptoms most often associated with long-term Covid, including respiratory problems, fatigue and loss of taste or smell, both in the phase before a diagnosis and in people who have not been diagnosed with the disease.
“This method allows us to take into account pre-existing symptoms and manifestations in uninfected people to offer an improved working definition for long-term Covid and provide a reliable estimate of how long the disease is likely to last in the general population.”
How the analyzes were performed
In the survey, experts collected data by asking participants in a large Dutch study called the Lifelines Covid-19 Cohort to regularly fill out digital questionnaires about 23 symptoms commonly associated with long-term Covid.
The questionnaire was sent 24 times to the same individuals between March 2020 and August 2021, meaning that participants who had the disease during that period were infected with the alpha variant of SARS-CoV-2 or earlier strains.
Most of the data was collected before the vaccine was available in the Netherlands, so the number of vaccinated participants was considered too small for analysis in the study. Participants were identified as positive for the disease if they had a test or medical diagnosis of the disease.
Of the 76,422 volunteers, 4,231 (5.5%) who had Covid-19 were compared with 8,462 people without the disease (called a control group), taking into account gender, age and time of filling out questionnaires that indicated a positive diagnosis.
The researchers identified that several symptoms were new or more severe three to five months after infection, compared with symptoms before diagnosis and with the control group, suggesting that these symptoms can be seen as the main symptoms of long-term Covid.
The main symptoms recorded were chest pain, difficulty breathing, pain when breathing, muscle pain, loss of taste or smell, tingling in the hands or feet, lump in the throat, alternating feeling of heat and cold, heavy arms or legs, general pain and tiredness.
According to the study, the severity of these symptoms stabilized in three months after infection, without showing a decline. Other symptoms that did not significantly increase three to five months after diagnosis were headache, itchy eyes, dizziness, back pain, and nausea.
“These core symptoms have major implications for future research, as they can be used to distinguish between the post-Covid-19 condition and non-disease-related symptoms,” explains one of the study’s authors, Aranka Ballering.
comparisons
Of the study participants who submitted data on pre-Covid symptoms, the researchers found that 21.4% (381/1,782) of the participants positive for the disease, compared with 8.7% (361/4,130) of the control group, had it. at least one symptom increased in moderate severity three months or more after infection.
According to the study, this implies that in 12.7% of infected patients, new or significantly increased symptoms three months after illness can be attributed to SARS-CoV-2 infection.
“By looking at symptoms in an uninfected control group and in individuals before and after SARS-CoV-2 infection, we were able to explain symptoms that may have been a result of health aspects of non-infectious diseases of the pandemic, such as stress caused by restrictions and uncertainties”, says Aranka.
Among the limitations of the study, the authors point out that the group analyzed includes patients infected with the alpha variant or previous strains of the coronavirus, which excludes data from people infected during the period when the delta or omicron variants predominated.
In addition, due to cases of asymptomatic infection, the prevalence of Covid-19 in the study may be underestimated. The study also does not include an ethnically diverse population, as it was carried out in a specific region of the Netherlands.
“Future research should include mental health symptoms for example symptoms of depression and anxiety, along with additional post-infectious symptoms that we were not able to assess in this study, such as mental confusion, insomnia and post-exertional malaise,” Judith said.
Researchers Christopher Brightling and Rachael Evans of the Lung Health Institute, University of Leicester, UK, who were not involved in the study, wrote in a related commentary:
“This is a major advance on previous Covid prevalence estimates as it includes a corresponding uninfected group and takes into account symptoms prior to infection. The pattern of symptomatology observed by Ballering and colleagues was similar to previous reports with fatigue and shortness of breath among the most common symptoms, but interestingly other symptoms, such as chest pain, were more characteristic of those with long-term Covid. versus uninfected controls,” they said.
For the Leicester researchers, current evidence supports the understanding that long-term Covid is common and can persist for at least two years, although severe wasting disease is present in a minority.
“The long case definition of Covid needs to be improved, potentially to describe different types of long Covid, for which a better mechanistic understanding is critical”, they conclude.
Exercise and physical therapy contribute to improved quality of life
Rehabilitation with the participation of a multidisciplinary team, involving physiotherapists, speech therapists, doctors and nutritionists, can bring benefits to the quality of life of patients with Covid-19.
“Symptoms such as loss of taste and smell were already signs of something very serious in relation to eating habits and it gets worse because of dysphagia (difficulty swallowing) resulting from prolonged intubation and tracheostomy”, says doctor Luciana Castilho de Figueiredo , supervisor of physiotherapy at the ICU at Hospital de Clínicas (HC) at Unicamp.
Patients can benefit from weight training with low or moderate loads, stretching, cardiorespiratory activities without overload (including exercise bike classes, provided there is not too much resistance on the pedals) or mobility-challenging activities such as training circuits (also with light loads). or moderate).
Physical trainer Rodrigo Sangion says that people who have shortness of breath should return to activities in a moderate way, respecting the limits indicated by their own body.
“With practice, there is a stimulus of physical and mental well-being, better conditioning of the cardiorespiratory system, greater muscle strength, in addition to helping with disease comorbidities, such as obesity,” said Sangion.
The expert recommends moderate physical activities that do not raise the heart rate above 70% of maximum effort capacity, such as walking.
Source: CNN Brasil
