For many, the impact of COVID-19 extends ‘well beyond’ the initial infection

Acute sequelae of SARS-CoV-2, also known as ‘long-term COVID’, include a wide range of symptoms that can persist for months after initial infection.

“Two years into the pandemic, we are beginning to see many patients with COVID-19 who are still symptomatic weeks and months later.” Michael A Horberg, MD, MAS, FACP, FIDSA,explained. “Our group was approached by the NIH, who asked if they could provide additional insight given that they have a large database of patients from the integrated network of the healthcare system. I did.”

According to Dr. Horberg, one fact became clear “immediately.” “No one has effectively compared these patients to the documented He COVID-19-negative group,” he said.

About the research published in Nature Communications, Dr. Horberg and colleagues used long-term data to identify acute sequelae of SARS-CoV-2 (PASC) within a 2020 patient cohort. “We included patients whose COVID-19 tests for PCR negative and PCR positive matched his 3:1 (negative vs. positive) based on month of testing, age, gender, and service area, so the actual Test patterns and test patterns are similar,” he explained. “We also considered his pre-existing condition for four years prior to COVID-19 testing.”

PASC risk is highest 30–120 days after initial infection

The study included 28,118 patients who tested positive for PCR and 70,293 patients who tested negative for PCR. Both the case and control groups consisted of more than 50% of her females, with a higher number of blacks and controls. Hispanic patient compared with Caucasian patients. Most of the patients (approximately 87%) he was younger than 65 years.

“We observed an increased risk of PASC in patients who tested positive for COVID-19, especially after 30 days,” Dr. Horberg said.

Researchers have identified 17 PASC-related disease (table)The risk of any PASC-related disease was 12% higher in the late PCR-positive patients, that is, 30 to 120 days after the PCR-positive test date, with significantly higher risks of anosmia, arrhythmia, diabetes, genitourinary disease, fatigue. chest pain, and nonspecific chest pain.

“It’s a wide spectrum of symptoms,” Dr. Horberg explained. “Patients who had respiratory symptoms during the acute phase of COVID-19 infection appeared to have more persistent symptoms.”

overall cumulative incidence of feed16.5%, as defined by COVID-19-positive patients with acute and persistent or late PASC-related diagnoses. “This is a little lower than the rates described in other studies,” Dr. Horberg said. “Importantly, however, many of these symptoms, especially in the acute phase, were common among patients who tested positive for COVID-19. It means it’s far beyond the initial infection.”

“The patient did not make up these symptoms.”

The research results are persistent symptoms The post-COVID-19 patient experience “is real and needs attention,” Dr. Horberg said. “Clinicians need to follow these patients closely.”

He suggests that clinicians “proactively ask questions” of patients infected with COVID-19.

“Patients are not making up these symptoms,” Dr. Horberg continued. “When I saw these results, I thought, ‘Wait a minute.’ We need to believe these patients and see their symptoms as real.” I want to use it as a target. I don’t need to worry. These results should expand the differential diagnosis. “

Clinicians should be especially vigilant. mental health According to Dr. Horberg, among patients with COVID-19 in terms of both worsening of previous mental health diagnoses and new onset mental health diagnoses. “During the stay-at-home orders in the early stages of the pandemic, patients may have been isolated and experienced fear and various phobias,” he said. , There may also be a biological reason, such as fatigue, but the biology is not yet fully understood, and until we know more, the new symptoms should not be taken lightly.”