Long COVID: Do Symptoms Depend on Variants?

Although new research suggests that Symptoms associated with long COVID vary Depending on the COVID-19 variant that the person is infected with, infectious disease experts say they are not completely convinced that this is the case.

The data are based on a study of 428 long COVID patients treated outpatiently after COVID between March 2020 and June 2021, but with the original strain of SARS-CoV-2. Both Alpha variants were in circulation. It is suggested that those infected with the alpha mutant encountered different neurological and emotional symptoms compared to those infected with the original strain of SARS-CoV-2.

There were more cases of muscle pain and pain, insomnia, brain fog, anxiety and depression among long COVID patients when the alpha mutant was the predominant strain. On the other hand, symptoms such as loss of smell, difficulty swallowing, and hearing loss were less common.

However, infectious disease experts question the accuracy of the study and point out the difficulty of assigning certain long COVID symptoms to different variants.

Dr. Christopher Carlsten is responsible for the Department of Respiratory Medicine at the University of British Columbia. He said he commends all efforts to better understand COVID-19, but is not yet convinced that alpha variants result in worse COVID-related syndromes than other mutants.

“This is a retrospective observational study and always raises the issue of bias. [this] He told CTV News.ca in a telephone interview on March 30th: Any of them claim that the variable that causes some pattern is dangerous. “

The study was published in an early news release prior to the European Clinical Microbiology and Infectious Diseases Conference later this month.

Dr. Nazeem Muhajarin, an epidemiologist at the University of Saskatchewan, said the design of the study does not seem to confirm which variants of the virus caused the infection in which patients. Instead, patients were evaluated based on whether they were infected when the original strain was predominant or when the alpha variant was predominant. This raises questions about the accuracy of the study, Muhajarin said.

“That’s a big limitation,” he told CTV News.ca on March 30 in a telephone interview. “Unless you actually take a sample and sequence it to find out, you really don’t know. [whether] This person was infected with alpha [or] The original virus.

“I’m a little uncertain that certain protracted symptoms may be associated with certain variants of SARS-CoV-2.”

However, Muhajarin said this remains an important area of ​​interest among COVID-19 researchers, and larger studies are needed to better understand the causes and effects of long COVIDs. I did. The authors of the study also state that more research is needed to better understand long COVIDs.

What do we know about LONG COVID?

Long COVID, also known as the acute sequelae of COVID-19 (PASC), occurs when the symptoms of the first COVID-19 infection last for more than 12 weeks after infection. At this point, experts usually expect the symptoms to go away. As a result, people with long COVIDs do not always test positive for the virus when using PCR or rapid antigen testing, Carlsten said.

“If the symptom persists beyond the infection, that is, if the bug becomes inactive within the measurable range and the symptom persists, it is considered a long COVID,” Carlsten said.

Long COVID is diagnosed in both, as explained in the study young Elderly patients, patients generally considered healthy, and patients with underlying health conditions. Recent studies have shown that About 30 percent Of those infected with COVID-19, long-term symptoms will appear. However, population-level studies assessing the prevalence of long-term COVID have not yet surfaced, so the exact proportions are still unknown, Muhajarin said.

Still, this situation is real and can affect a significant number of people, Karsten said.

“Even a small percentage of COVID patients with long-term symptoms are many,” he said. “Rather than being too obsessed with the exact percentage at this point, it’s a non-trivial percentage, and at the population level it’s pretty clear that it means a lot of people.”

The recent advent of Omicron could cause long-term COVIDs in people infected with the latest substances of concern, Karlsten said.

“The basic answer is yes. For me, there is no doubt that Omicron can result in a long COVID,” Carlsten said. “I think it’s just how many problems there are. The opposite answer is that I don’t know. At this point I don’t know if anyone can tell you.”

Given that the world only knows about the Omicron variant for a few months, Muhajarin has yet another set of long COVID symptoms to determine the relationship between Omicron and long COVID. He said he needed more time to determine if it could be associated with. Compared to the previous one.

“We are just at that threshold in terms of whether Omicron leads to longer COVIDs, and whether it leads to longer COVIDs compared to previous variants,” he said. .. “I think even the long definition of COVID is really at the top, so I think we need to give more weeks and months to actually be able to say that.”

According to Karlsten, the notion that different symptoms are associated with different COVID-19 mutants is not new. This is due to the slight differences in the amount and type of mutations that each variant has, and various symptoms can occur when a person is infected, Muhajarin said. But these differences are usually not noticeable, Karsten said.

“In the process of a pandemic, there seems to be more similarity in the symptomatology associated with COVID than in the strains,” he said.

Generalized symptom diagnosis hurdles

Generally reported Symptoms of long COVID Shortness of breath, chronic fatigue, sleep disorders, visual impairment, and brain fog. A Spike heart rate It also seems to be linked to a long COVID.One international study 203 symptoms You can connect to a long COVID, but the most common are fatigue, tiredness, Cognitive dysfunction..

One of the challenges in understanding the cause of long COVID lies in the fact that many of the symptoms associated with it are fairly generalized, Carlsten said.

“The fundamental annoyance of long COVIDs is the absence of a specific, or even remote, specific single symptom,” he said. “They are, by definition, very common symptoms of other illnesses and other medical problems.”

This also makes it very difficult to diagnose and treat the condition, Karsten said.

“The basis of diagnosis is that the more specific the characteristics, the easier it is to diagnose,” says Carlsten. “But because they are non-specific … they are more difficult to diagnose and correspondingly more difficult to treat.”

According to Muhajarin, there is no single test used to diagnose long COVIDs, but specific tests are possible. Used to identify common symptomsIncludes blood tests, heart rate and blood pressure checks, electrocardiogram, and chest x-ray.Although experts started, it doesn’t even look like there is a single treatment or dosing for long COVID, he said. Try to tackle this question.. So far, it seems that the focus is not on the condition itself, but on the treatment of some of the symptoms associated with long COVID. For example, it could include patient rehabilitation to help with breathing and lung function, Muhajarin said.

The UK National Health Technology Assessment Organization provides national guidance for improving health care. Submit a proposal For managing and processing long COVIDs, including a hierarchical approach. It begins with patient-led rehabilitation based on self-care and progresses to recovery guided by a general practitioner or specialist, depending on the severity of the condition. Muhajarin said this proved to be an effective approach to managing long-term COVID in Canadian patients.

“At the start gate” of LONG COVID management

This may give people the idea that COVID-19 is a thing of the past, as restrictions continue to be lifted in parts of Canada, but especially when considering the possibility of developing a long COVID. Muhajarin is not. As a result, Karsten said it was important to continue efforts to better understand the condition.

“It’s a big problem we need to keep trying to understand,” Carlsten said. “I think we should continue our research, despite the fact that this is a large population-level issue and is incredibly unclear from a long COVID perspective.”

Muhajarin is also looking for a medical system to open more clinical facilities dedicated to outpatient treatment of long COVID patients.States such as Ontario When British Columbia According to Muhajarin, the COVID clinic has been in operation for a long time, but not in states such as Saskatchewan.

“Unfortunately, we are still at the starting point for dealing with long COVIDs in this country,” he said. “I’ve heard stories from people who have been experiencing long COVID symptoms, but they feel they’re staying high and dry to deal with this on their own.

“This is the legacy that Acute COVID-19 is trying to leave to us, and that’s why we can’t underestimate COVID-19.”

Muhajarin is also calling on the public health system to build patient enrollments among people who have long experience with COVID. By collecting data about these patients, including medical history and details of previous infections, this helps to better identify patterns that can be used to more easily diagnose the condition, he said. ..

“First of all, we can identify who has these symptoms … Second, we can monitor them,” Muhajarin said. “You can understand who they are, where they live, what their history was at COVID-19, and what services are available.

“If the long COVID is this large canvas we need to paint, in many parts of Canada, including my state, there are few dots of paint on the canvas.”

————

What questions do you have about Omicron?

CTVNews.ca would like to hear any questions from Canadians as a new strain of COVID-19 of concern, labeled Omicron, emerges.

What do you want to know about the Omicron COVID-19 variant?

To send a question, please email us at the following address: [email protected] By your name, location, question. Your comments may be used in the CTVNews.ca story.