Severe COVID-19 may be associated with long-distance symptoms

According to a new study from the University of Michigan, people who are experiencing a very severe COVID-19 infection have a higher prevalence of persistent symptoms.

The findings characterize long-haul carriers, those who continue to experience prolonged symptoms months after the initial diagnosis, highlighting the urgent need for treatment. Symptoms of SARS-CoV-2 infection (PASC), called acute sequelae, include extreme fatigue, shortness of breath, and persistent loss of taste and smell.

“We are trying to stop the pandemic epidemic, but we need to develop formal and coordinated monitoring of long-term symptoms to better understand the syndrome and provide guidance for clinical management. “There is,” said lead author Jana Hirschtick. Researcher at the Center for Social Epidemiology and Population Health at UM School of Public Health.

Hirschtick et al. Found that 53% of COVID-19 survivors had persistent symptoms 30 days after the onset of COVID and 35% had symptoms 60 days after the onset of COVID.

For their analysis, the researchers Michigan COVID-19 Recovery Monitoring StudyA population-based study of adults aged 18 years and older with the SARS-CoV-2 test confirmed by PCR on the Michigan Disease Surveillance System. All non-institutionalized adults with valid phone numbers and zip codes or MDSS counties that were alive at the time the study sample was extracted were selected.

The UM research team collected a random sample of 2,000 adults with COVID-19 who developed before April 15, 2020 in 13 geographic regions and 6 counties (McComme, Auckland, St. Clair, Monroe, Washtenaw, Wayne). ) And used from one city (Wayne). Detroit) Michigan. Of the sample, 629 completed the survey between June and December 2020.

Researchers estimated the prevalence of persistent symptoms 30 and 60 days after the onset of COVID-19, including sociodemographic and clinical factors, as well as self-reports. Symptomatology Severity and hospitalization.

Their final sample (593), including data available for the study, was primarily female (56%), ages 45 and older (68%), and non-Hispanic whites (46%) or blacks (35%). .. Among the respondents:

• 53% reported symptoms in 30 days and 35% reported symptoms in 60 days.
• Respondents who reported very severe (mild) symptoms were 2.25 times more prevalent at 30 days and 1.71 times more prevalent at 60 days.
• Respondents who were hospitalized (not hospitalized) had an approximately 40% higher prevalence of symptoms at 30 and 60 days.
• Persistent symptoms were more common among older and severely ill respondents, while 21% of 18-34 year olds and 25% of respondents who reported mild illness were COVID-19. There were symptoms 60 days after the onset.
• Senior citizens, Low incomeSelf-reported severe or very severe (to mild) symptoms and hospitalization statistically significantly predict 30 days COVID-19, and if psychological disorder is diagnosed, very severe symptoms and hospitalization are statistical Significantly predicted 60-day COVID-19.

“Our data suggest that a significant proportion of people with COVID-19 continue to experience symptoms, even among people with relatively mild early-stage disease,” said Michigan COVID-19 recovery. Said Nancy Freisher, an associate professor of surveillance research and a principal investigator.

Due to the clear definition of the disease and the lack of population-based studies, prevalence estimates vary widely, researchers say. Their study used a population-based sample of COVID-19 cases diagnosed in Michigan to provide estimates of PASC prevalence and attempted to assess the demographic and clinical correlation of PASC. did.

After adjusting the model, the researchers also discovered that:

• There was no statistically significant difference in 30 or 60 day COVID-19 by race / ethnicity.
• Annual household income was a powerful and important predictor of COVID-19 for 30 days. Even after adjusting for demographic and clinical factors, respondents with incomes less than $ 75,000 had an approximately 40% higher prevalence of COVID-19 for 30 days than respondents with incomes greater than $ 75,000. ..
• In a fully tuned model, income was not significantly associated with 60-day COVID-19.
• Psychological respondents had a 42% higher prevalence of COVID-19 for 60 days.
• The severity of self-reported acute illness was strongly associated with both 30-day and 60-day COVID-19.

“These results provide increasing evidence that a significant proportion of symptomatological COVID-19 cases of varying severity experience PASC,” Freisher said. “People have been suffering from symptoms long after their first illness, and the medical and public health community needs to help cope with this ongoing crisis.”

Within the limits of the study, the sample includes individuals who developed COVID-19 in Michigan early in the pandemic. At this time, access to the test was restricted, which could limit the generalization of the findings.

The Michigan COVID-19 Recovery Monitoring Survey has data on respondents who developed COVID-19 by September 2020 and will investigate PASC within this larger group of respondents. In addition, researchers will examine the characteristics and predictors of different subsets of PASC symptoms that may represent different syndromes.