Incidence, co-occurrence & evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19, 2021, Taquet et al

Abstract

Background
Long-COVID refers to a variety of symptoms affecting different organs reported by people following Coronavirus Disease 2019 (COVID-19) infection. To date, there have been no robust estimates of the incidence and co-occurrence of long-COVID features, their relationship to age, sex, or severity of infection, and the extent to which they are specific to COVID-19. The aim of this study is to address these issues.

Methods and findings
We conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors. The incidence and co-occurrence within 6 months and in the 3 to 6 months after COVID-19 diagnosis were calculated for 9 core features of long-COVID (breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression). Their co-occurrence network was also analyzed. Comparison with a propensity score–matched cohort of patients diagnosed with influenza during the same time period was achieved using Kaplan–Meier analysis and the Cox proportional hazard model. The incidence of atopic dermatitis was used as a negative control.

Among COVID-19 survivors (mean [SD] age: 46.3 [19.8], 55.6% female), 57.00% had one or more long-COVID feature recorded during the whole 6-month period (i.e., including the acute phase), and 36.55% between 3 and 6 months. The incidence of each feature was: abnormal breathing (18.71% in the 1- to 180-day period; 7.94% in the 90- to180-day period), fatigue/malaise (12.82%; 5.87%), chest/throat pain (12.60%; 5.71%), headache (8.67%; 4.63%), other pain (11.60%; 7.19%), abdominal symptoms (15.58%; 8.29%), myalgia (3.24%; 1.54%), cognitive symptoms (7.88%; 3.95%), and anxiety/depression (22.82%; 15.49%). All 9 features were more frequently reported after COVID-19 than after influenza (with an overall excess incidence of 16.60% and hazard ratios between 1.44 and 2.04, all p < 0.001), co-occurred more commonly, and formed a more interconnected network. Significant differences in incidence and co-occurrence were associated with sex, age, and illness severity. Besides the limitations inherent to EHR data, limitations of this study include that (i) the findings do not generalize to patients who have had COVID-19 but were not diagnosed, nor to patients who do not seek or receive medical attention when experiencing symptoms of long-COVID; (ii) the findings say nothing about the persistence of the clinical features; and (iii) the difference between cohorts might be affected by one cohort seeking or receiving more medical attention for their symptoms.

Conclusions
Long-COVID clinical features occurred and co-occurred frequently and showed some specificity to COVID-19, though they were also observed after influenza. Different long-COVID clinical profiles were observed based on demographics and illness severity.

Open access, https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003773

 

People also suffer 'long flu', study shows

People who have fallen ill with flu can suffer long-term symptoms in a similar way to long Covid, a study suggests.

The Oxford University research analysed health records of people diagnosed with flu and Covid, mainly in the US.

The two groups - both with just over 100,000 patients - included people seeking healthcare for symptoms three to six months after infection.

These included problems such as anxiety, abnormal breathing, fatigue and headaches.

There were signs that Covid patients were more likely to have long-term symptoms - 42% had at least one symptom recorded compared with 30% in the flu group.

https://www.bbc.co.uk/news/health-58726775

 

Interesting study.

Although the prevalence of long-covid related symptoms was higher in the group that had a coronavirus infection compared to the influenza group, I was surprised the percentage was actually quite low for fatigue (ca. 6%) and cognitive symptoms (ca. 4%)

 

If this is retrospective from health records it's guaranteed to be an undercount, those are very unreliable for this kind of issue.

Although it's clear that one strategy moving forward will be to pretend that medicine has always known about "post-viral fatigue", it's common, and knows how to deal with it already. Anything to avoid admitting to the worst failure of expertise in human history, also massively incompetent and unethical, but that's sunk cost mixed with total power imbalance for you.

And such are the stakes with NICE and Cochrane, literally the entire concept of "behavioral disorders" masquerading as disease is on the line, with patients on one side and medicine on the other, one with everything to lose, the other with all the power. What a weird dynamic, even for weird dystopian fiction it would be a bit over the top.

 

Sept. 29 article from NPR about this study:

https://www.npr.org/sections/corona...87/coronavirus-long-covid-study-plos-medicine

 

Trial By Error: BBC’s Problematic Coverage of New Long COVID Study

"Since the start of the coronavirus pandemic, suggesting an equivalence between COVID-19 and influenza has been a consistent approach among those seeking to downplay the current situation. So it’s not surprising to see something similar happen with comparisons between Long COVID and the delayed recovery some people experience after an acute bout of the flu. The BBC has just provided an excellent example of how this framing can appear to minimize the significance of Long COVID.

An article in PLoS Medicine, published on September 28th, offered a look at Long COVID symptoms based on data from US electronic health records. The study, called “Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19,” tracked nine key symptom clusters: “breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression.”"

https://www.virology.ws/2021/10/03/trial-by-error-bbcs-problematic-coverage-of-new-long-covid-study/

 

"retrospective"... We needed prospective studies.

 

As I have written before, long before I knew about ME but I was moderately ill, my husband had a bad flu but was forced back to work as soon as his fever dropped because our young, arrogant, horrible G would not give an insurance line to a young person.

He was pale, weak, lost weight and could hardly stand. The people he worked with were very good, giving him lifts, letting him work sitting down and so on so he got a bit better but for abut 9 months he went to bed as soon as he got home and at weekends. After about a year, can't remember now, he suddenly felt better.

It never occurred to us he had the same as me. I never felt fatigued it was go or stop altogether and he had none of the weird symptoms like having to wear sunglasses indoors or not being able to speak.

The list of symptoms may seem the same, but only if you put the emphasis on fatigue and miss out a lot of things you get in ME.