Post-viral symptoms and conditions are more frequent in COVID-19 than influenza, but not more persistent, 2024, Tesch

[Dolphin]

[CFS is referred but I don't think they say how they define it]

https://www.researchsquare.com/article/rs-3870058/v1

Post-viral symptoms and conditions are more frequent in COVID-19 than influenza, but not more persistent

Falko Tesch1

Email

Franz Ehm1

Friedrich Loser2

Annika Vivirito3

Danny Wende4

Manuel Batram5

Lars Bechmann6

Tilo Buschmann7

Simone Menzer6

Marion Ludwig8

Martin Roessler4

Martin Seifert1

Giselle Sarganas Margolis9

Lukas Reitzle9

Christina König2

Claudia Schulte4

Dagmar Hertle4

Pedro Ballesteros4

Stefan Baßler7

Barbara Bertele2

Thomas Bitterer6

Cordula Riederer10

Franziska Sobik10

Christa Scheidt-Nave11

Jochen Schmitt1

1 University Hospital and Faculty of Medicine Carl Gustav Carus at TU Dresden,

2 Techniker Krankenkasse,

3 InGef - Institute for Applied Health Research Berlin GmbH,

4 BARMER Institut für Gesundheitssystemforschung (bifg),

5 Vandage GmbH,

6 IKK classic,

7 AOK PLUS,

8 InGef - Institute for Applied Health Research Berlin,

9 Robert Koch Institute,

10 DAK-Gesundheit,

11 Robert Koch Institut

https://doi.org/10.21203/rs.3.rs-3870058/v1

This work is licensed under a CC BY 4.0 License

Post-viral symptoms have long been known in the medical community but have received more public attention during the COVID-19 pandemic.

Many post-viral symptoms were reported as particularly frequent after SARS-CoV-2 infection.

However, there is still a lack of evidence regarding the specificity, frequency and persistence of these symptoms in comparison to other viral infectious diseases such as Influenza.

We addressed this topic by investigating a large population-based cohort based on German routine healthcare data.

We matched 573,791 individuals with a PCR-test confirmed SARS-CoV-2 infection from the year 2020 to contemporary controls without SARS-CoV-2 infection and controls from the last Influenza outbreak in 2018 and followed them up to 18 months.

We found that post-viral symptoms as defined for COVID-19 by the WHO as well as tissue damage were more frequent among the COVID-19 cohort than the Influenza cohort.

Persistence of post-viral symptoms was however similar between COVID-19 and Influenza.

We conclude that post-viral symptoms following SARS-CoV-2 infection constitute a substantial disease burden as they are frequent and often persist for many months.

As COVID-19 is becoming endemic, the disease must not be trivialized.

Research should focus on the development of effective treatments for post-viral symptoms.

 

[Andy]

Now published

Post-viral symptoms and conditions are more frequent in COVID-19 than influenza, but not more persistent

Abstract

Background
Post-viral symptoms have long been known in the medical community but have received more public attention during the COVID-19 pandemic. Many post-viral symptoms were reported as particularly frequent after SARS-CoV-2 infection. However, there is still a lack of evidence regarding the specificity, frequency and persistence of these symptoms in comparison to other viral infectious diseases such as influenza.

Methods
We investigated a large population-based cohort based on German routine healthcare data. We matched 573,791 individuals with a PCR-test confirmed SARS-CoV-2 infection from the year 2020 to contemporary controls without SARS-CoV-2 infection and controls from the last influenza outbreak in 2018 and followed them up to 18 months.

Results
We found that post-viral symptoms as defined for COVID-19 by the WHO as well as tissue damage were more frequent among the COVID-19 cohort than the influenza or contemporary control cohort. The persistence of post-viral symptoms was similar between COVID-19 and influenza.

Conclusion
Post-viral symptoms following SARS-CoV-2 infection constitute a substantial disease burden as they are frequent and often persist for many months. As COVID-19 is becoming endemic, the disease must not be trivialized. Research should focus on the development of effective treatments for post-viral symptoms.

Open access, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-10059-y

 

[rvallee]

Not more persistent. Just as persistent. An important change in framing. And actually a bit higher for records of CFS.

This study isn't very accurate as it relies on health records, although a difference here is that they use health insurance records. At best it's a massive undercount. At least they tried to account for this:

Although the ICD-10 catalog lists codes for post-viral disease (B94.8) and as of 2021 also for post-COVID condition (U09.9), these codes may largely underestimate the proportion of affected patients [14]. For this reason, we follow the widely used strategy to define post-COVID by symptoms and conditions associated with it. Based on published literature, previous work developing a core outcome set [15], and the clinical expertise of the author team, we selected a large set of 96 outcomes covering multiple organ systems and diagnosis/symptom complexes

Of these 96 symptoms and conditions, seven were selected to represent the WHO post-COVID clinical case definition (malaise/exhaustion, chronic fatigue syndrome, dyspnea, respiratory insufficiency, chest pain, cognitive impairment, memory disorder

Not great, but can't really do much better given the knowledge that data is corrupted at input. Both the recent COVID data and all historical data related to other infectious diseases.

Decades of having mislabeled health records on purpose are really screwing us here. If health care systems had behaved like professionals and recorded data accurately we would be so much better able to deal with this. But, nooooo, that would have "enabled the sick role". Or encouraged tiktok sickfluencers to promote the social vapors. Or whatever some want to believe is going on with this.

Reading how they approached the data, they seem to be making a real effort here. Much better than average, but that's a bar low enough to power a hypercane. This is overall frankly pretty good and well-reasoned and as best as can be done with corrupted data:

This, together with the appearance of the Omicron variant in January 2022, has increased the size of the COVID-19 cohort to such an extent that the contemporary control cohort is contaminated for further analyses

Oddly, this replicated finding has been used to argue that there is no need to bother, when what it actually does is invalidate decades of denial, that this is a serious issue from even common infectious illnesses. If only we lived in a sane world...

 

[Peter T]

It would be interesting to know reliably that different viral infections have different rates or types of long term sequelae as would appear to be the case, unfortunately I suspect this study falls very short of that.

Presumably influenza was choice as a comparator for reasons of convenience though I would expect it to be much less interesting than a range of other viral conditions including EBV triggered glandular fever (mono). In relation to influenza itself I would want to know what strains were involved and if there were differences between long established and novel strains.

Are the high levels of post viral ongoing sequelae following Covid a reflection of the nature of Sars viruses or of the novelty of the current Covid strains? If different viruses or different strains of the same virus produce different long term effects, this would put pay to people waffling on about pandemic stress as a trigger for such as Long Covid.