Long-term symptoms of mild Covid disappear within a year, study says

Long-term symptoms of mild Covid disappear within a year, study says

Long-term symptoms of mild Covid disappear within a year, study says


Most long-term symptoms of Covid disappear within the first year after infection in people with mild cases of Covid-19, according to a large study conducted in Israel.

“Mild disease does not lead to severe or chronic long-term morbidity in the vast majority of patients,” study co-author Barak Mizrahi, a senior researcher at the KI Research Institute in Kfar Malal, said via email.

Study, published Wednesday in The BMJ, compared thousands of vaccinated and unvaccinated people with mild Covid symptoms who were not hospitalized with people who tested negative for the virus. Long-term Covid is defined as symptoms that last or appear more than four weeks after the initial infection with Covid-19.

“I think this study is encouraging because most ongoing post-COVID symptoms do improve during the first few months after acute infection,” said Dr. Benjamin Abramoff, director of the Penn Medicine Post-COVID Assessment and Recovery Clinic, via email. He was not involved in the study.

But not for everyone. Abramoff said his clinic continues to see many patients with severe, lingering Covid symptoms that last more than a year after infection.

Long-term symptoms of mild Covid disappear within a year, study says

“This is particularly true in those individuals who have had severe persistent symptoms early after an acute infection,” said Abramoff, who leads Long cooperation of the American Academy of Physical Medicine and Rehabilitation in the fight against Covid.

dr. Jonathan Whiteson, associate professor of rehabilitation medicine at NYU Grossman School of Medicine, sees the same in his clinic.

“I continue to see many patients from the ‘first wave’ of COVID who had mild to moderate acute COVID (and were never hospitalized) who have significant persistent and functionally limiting symptoms nearly 3 years later,” Whiteson said via email. . He was not involved in the study.

Israeli researchers analyzed the medical records of nearly 300,000 people diagnosed with mild cases of Covid-19 and compared their health over the next year with approximately 300,000 people who did not have Covid. The average age of those who tested positive for Covid is 25, and 51% were women.

The researchers looked for 65 conditions that were associated with long-term Covid and divided them into two time frames: early, or the first 30 to 180 days after contracting Covid; and late or 180 to 360 days after infection.

After controlling for age, gender, alcohol and tobacco use, pre-existing conditions and different variants of Covid-19, the researchers found a significant risk of brain fog, loss of smell and taste, breathing problems, dizziness and weakness, palpitations and sore throat in early and late period.

Chest pain, cough, hair loss, muscle and joint pain, and respiratory distress increased significantly only during the early phase, according to the researchers.

Difficulty breathing was the most common complaint, the survey found. Vaccination reduced the risk of respiratory problems, but researchers found that vaccinated individuals had “similar risk for other outcomes compared with unvaccinated infected patients,” according to the study.

“Because of the size of the study, it was possible to look at changes in the prevalence of symptoms over time and the effects of other factors on persistent symptoms,” said Dr. Peter Openshaw, professor of experimental medicine at Imperial College London, in a statement.

“Olfactory disturbances usually resolved after about 9 months, but when they were present, the concentration and memory changes were more persistent,” said Openshaw, who was not involved in the study.

The study showed only small differences between men and women, but children had fewer early symptoms than adults, which mostly disappeared by the end of the year. No real differences were found between the original wild-type SARS-CoV-2 (March 2020 until November 2020), Alpha variant (January 2021 until April 2021) and the Delta variant (July 2021 until October 2021).

“Patients with mild Covid-19 had an increased risk for a small number of health outcomes, with only a few symptoms present one year after SARS-CoV-2 infection and their risk decreasing with time after infection,” Mizrahi said via email. mail.

However, “we are not claiming that there are no patients suffering from long-term symptoms of COVID such as dyspnea (difficulty breathing), weakness, cognitive impairment, etc.,” he added. “(Our study) does not contradict the evidence that a small number of patients suffer from long-term symptoms as seen in this analysis.”

The researchers pointed out certain limitations of the study, such as the possibility of diagnostic errors or the failure to record some milder symptoms over time. Abramoff agreed.

“This study design cannot detect the severity of these symptoms, and there are potentially other missed patients due to the use of medical coding to detect long-term symptoms of COVID,” Abramoff said.

It may also be difficult to apply the study’s findings to other countries, such as the United States, because of differences in how doctors code symptoms. For example, the study did not identify several conditions commonly found in long-term Covid clinics in the US, said Dr. Monica Verduzco-Gutierrez, professor and chair of the department of rehabilitation medicine at the Long School of Medicine at UT Health, San Antonio.

“The most common symptom of long-term COVID is fatigue, and that was not on this list. Post-exertional malaise, dysautonomia/POTS or ME/CFS were also absent. These are some of the main presentations that I see in my clinical population, so a big limitation of this study is not having those results,” said Verduzco-Gutierrez, who was not involved in the new study.

Weakness after exertion is massive exhaustion even after a minimal amount of effort. Unlike regular exhaustion, it can take days or weeks for a person to recover, and weakness can reactivate if activity is resumed too quickly.

Postural orthostatic tachycardia syndrome, or POTS, is a rapid heartbeat after sitting or standing that can lead to dizziness or fainting. It is a form of dysautonomia, disorder of the autonomic nervous system. “There is usually no cure for dysautonomia,” according to the National Institute of Neurological Disorders and Stroke.

Myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS, is a serious long-term illness in which people have overwhelming fatigue that does not improve with rest. The condition can affect sleep and thinking processes, cause pain in many parts of the body and prevent people from carrying out most daily activities.

Responding to this concern, Mizrahi told CNN that “post-exertional discomfort was not included in this study because it is not a commonly prescribed diagnosis in Israel.” In addition, he said, dysautonomia/POTS has only been assigned an International Classification of Diseases or ICD medical code since October 2022, so it was not included in the study either.

However, symptoms of POTS and other conditions may be included in more general categories such as heart arrhythmias or palpitations, he said.

In addition, Mizrahi said fatigue was coded under “weakness” in the study. In fact, the researchers found that weakness was the second most commonly reported symptom in the study, and it continued to plague people ages 19 to 60 for months.


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