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▎The content team editor of WuXi AppTec.
In the new crown epidemic, the long-term symptoms of previously infected people after recovery are also attracting more research attention, especially some patients with mild symptoms at the beginning, but also long-term lingering in the later period.
Do not go to health problems
.
Different people have different symptoms.
This phenomenon is called "Long COVID" (Long COVID), and these previously infected people are called "Long-Haulers" (Long-Haulers)
.
What are the characteristics, severity, and duration of these symptoms? We do not yet have a full picture
.
However, recently, the journal EClinicalMedicine under the "Lancet" published an important large-scale study, giving us a more systematic understanding of the "Long New Crown"
.
This study was jointly led by University College London and patient organizations.
Through feedback from 3,762 patients from 56 countries, more than 200 symptoms of "long new crown" in 10 organ systems were collected.
These symptoms are very harmful to patients.
The ability to work and perform daily tasks have a huge impact
.
"This is the most comprehensive representation of the symptoms of the'long-term new crown' so far
.
" said the corresponding author of the study, Dr.
Athena Akrami, a neuroscientist at University College London.
"In this study, we directly build the evidence through the subjects of these long-term symptoms.
Foundation to improve medical research and diagnosis and treatment
.
Screenshot source: EClinicalMedicine.
In this study, the research team and the COVID-19 patient support organization launched an online survey with 257 questions to describe the symptoms and course of the "long COVID-19" patients, as well as their daily life, The impact of work and health recovery
.
During the period from September 6, 2020 to November 25, 2020, a total of 3762 confirmed cases (test positive, 1020) or suspected (test negative or untested, 2742) from 56 countries were collected and included Example) long-term symptoms of the new crown patients, their symptoms for 28 days, and had already appeared in 2020 in June
.
based on these data, the research team identified 10 affected system altogether 203 kinds of symptoms, and 66 The effects of these symptoms were followed for seven months
.
The common symptoms of 10 organ systems are as follows: systemic effects: such as chills, abnormal body temperature, fatigue, weakness, post-exertional malaise; urinary, reproductive and endocrine systems: menstruation Abnormalities, abnormal bladder control, thirst, abnormal blood sugar, etc.
; cardiovascular system: bradycardia, fainting, palpitations, tachycardia, chest pain, vein swelling, etc.
; musculoskeletal system: bone headache, joint pain, muscle aches, chest tightness ; Immune system: new or more obvious allergic reactions; facial features (head, ear, nose, and throat): hearing loss, tinnitus, abnormal vision, runny nose, sore throat, etc.
; lungs and other respiratory systems: difficulty breathing, shortness of breath, Shortness of breath, hemoptysis, dry cough, mucus coughing, sneezing, etc.
; Digestive system: abdominal pain, constipation, diarrhea, loss of appetite, gastroesophageal reflux, nausea, vomiting, etc.
; Skin: skin allergies, peeling, petechiae, rash, etc.
; neuropsychiatric system: cognitive dysfunction, memory abnormalities, language barriers, nerve paresthesia, sleep, headaches, mood disorders, taste and smell abnormalities, hallucinations and so on
.
duration of symptoms over 35 weeks most of the data shows that the majority (91.
8% ) For patients who have experienced the "long-term COVID-19", their long-term symptoms persist for more than 35 weeks
.
Among the 3762 respondents, 3608 (96%) reported symptoms for more than 90 days; 2454 (65%) had symptoms for at least 6 months, except for 1,075 people who had been ill for less than 6 months at the time of the survey, only 233 people (6.
2%) recovered within 6 months
.
In terms of severity, the probability of "severe" and "very severe" symptoms peaked during acute infection (<28 days), while the probability of "moderate" and "mild" gradually increased thereafter
.
▲As time goes by, the probability of symptoms of different severity (picture source: reference [1]) is based on the 66 symptoms that the research team has tracked for a long time: among those patients who recovered within 90 days, the average number of symptoms reached the peak in the second week (11.
35 symptoms), and gradually decreased thereafter; while patients who did not recover within 90 days, the average number of symptoms reached a peak in the second month (17.
16 symptoms), and the number of symptoms decreased slowly thereafter, and it is likely that they will still suffer for a longer period of time.
A variety of symptoms are troubled; in patients with symptoms more than 6 months, an average of 13.
8 symptoms appear in the 7th month
.
▲The average number of symptoms reported by different groups of people over time
.
Green-recovery within 90 days, purple-no recovery within 90 days
.
(Image source: Reference [1]) There are many symptoms and a wide range of effects.
Among all 203 symptoms, these patients experienced an average of 55.
9 symptoms, involving 9.
1 organ systems during the "long COVID-19" period
.
Almost all "long-term COVID-19" patients experience systemic (99.
7%) and facial features (100%) symptoms
.
More than 85% of patients with "long new crown" have musculoskeletal, cardiovascular, digestive, pulmonary, and neuropsychiatric symptoms
.
The most common symptoms include fatigue (98.
3%), discomfort after exertion (89.
1%) and cognitive dysfunction (85.
1%)
.
These patients believed that the three symptoms that made them feel weak were fatigue (2652 people, 70.
5%), breathing problems (2242 people, 59.
6%), and cognitive dysfunction (1274 people, 33.
9%)
.
Image source: 123RF relapses frequently and recovery is difficult.
85.
9% of patients experienced recurrence of symptoms.
The main predisposing factors were physical activity (70.
7%), stress (58.
9%), exercise (54.
39%) or mental activity (46.
2%)
.
Among patients whose symptoms persisted for more than 6 months, more than 50% had the following symptoms: fatigue (80%), discomfort after exertion (73.
3%), cognitive dysfunction (58.
4%), sensory motor symptoms (55.
7%), Headache (53.
6%) and memory problems (51%)
.
In addition, 30%-50% of patients will also experience the following symptoms: insomnia, heart palpitations, muscle aches, shortness of breath, dizziness and balance problems, sleep and language problems, joint pain, tachycardia, and other sleep problems
.
Dr.
Akrami specifically emphasized, “Memory and cognitive dysfunction are the most common and long-lasting neurological symptoms, which are equally common at all ages and have a significant impact on work
.
Other symptoms are also common, which may indicate the central nervous system.
There are extensive problems with the peripheral nervous system
.
"These symptoms of the "long-term new crown" have seriously affected the work of the patient
.
Compared with before the illness, only 27.
3% of the patients had no change in their working hours, 45.
2% of the "long COVID-19" patients shortened their working hours, and 22.
3% were unable to work due to illness when participating in the survey
.
Picture source: The 123RF paper pointed out that 7 months after the onset, there are still many patients who have not recovered.
They are mainly affected by systemic symptoms and neurological/cognitive symptoms.
They have not returned to their previous work levels and continue to suffer serious Symptom burden
.
The research team stated that the research has its limitations.
For example, retrospective research is affected by patient recall bias; research is distributed through patient organizations, which generally provide assistance to patients with “long-term COVID-19,” which may lead to sampling bias; population diversity is limited, Most of the included patients were English-speaking patients
.
However, other studies have also shown that about one-seventh of new crown patients still have symptoms at 12 weeks, and the number of "long-term new crown" patients may be very large
.
But overall, Dr.
Akrami pointed out: “This study reveals for the first time that a wide range of symptoms, especially neurological symptoms, are common and persistent in patients with'long-term new crown'
.
” At present, relevant clinical guidelines are effective for long-term recovery of patients with new crown.
The guidance mainly focuses on cardiovascular and respiratory function tests.
The research team recommends that the evaluation scope of the "long new crown" be further expanded to include symptoms of mental, neurological and activity intolerance
.
In the new crown epidemic, the long-term symptoms of previously infected people after recovery are also attracting more research attention, especially some patients with mild symptoms at the beginning, but also long-term lingering in the later period.
Do not go to health problems
.
Different people have different symptoms.
This phenomenon is called "Long COVID" (Long COVID), and these previously infected people are called "Long-Haulers" (Long-Haulers)
.
What are the characteristics, severity, and duration of these symptoms? We do not yet have a full picture
.
However, recently, the journal EClinicalMedicine under the "Lancet" published an important large-scale study, giving us a more systematic understanding of the "Long New Crown"
.
This study was jointly led by University College London and patient organizations.
Through feedback from 3,762 patients from 56 countries, more than 200 symptoms of "long new crown" in 10 organ systems were collected.
These symptoms are very harmful to patients.
The ability to work and perform daily tasks have a huge impact
.
"This is the most comprehensive representation of the symptoms of the'long-term new crown' so far
.
" said the corresponding author of the study, Dr.
Athena Akrami, a neuroscientist at University College London.
"In this study, we directly build the evidence through the subjects of these long-term symptoms.
Foundation to improve medical research and diagnosis and treatment
.
Screenshot source: EClinicalMedicine.
In this study, the research team and the COVID-19 patient support organization launched an online survey with 257 questions to describe the symptoms and course of the "long COVID-19" patients, as well as their daily life, The impact of work and health recovery
.
During the period from September 6, 2020 to November 25, 2020, a total of 3762 confirmed cases (test positive, 1020) or suspected (test negative or untested, 2742) from 56 countries were collected and included Example) long-term symptoms of the new crown patients, their symptoms for 28 days, and had already appeared in 2020 in June
.
based on these data, the research team identified 10 affected system altogether 203 kinds of symptoms, and 66 The effects of these symptoms were followed for seven months
.
The common symptoms of 10 organ systems are as follows: systemic effects: such as chills, abnormal body temperature, fatigue, weakness, post-exertional malaise; urinary, reproductive and endocrine systems: menstruation Abnormalities, abnormal bladder control, thirst, abnormal blood sugar, etc.
; cardiovascular system: bradycardia, fainting, palpitations, tachycardia, chest pain, vein swelling, etc.
; musculoskeletal system: bone headache, joint pain, muscle aches, chest tightness ; Immune system: new or more obvious allergic reactions; facial features (head, ear, nose, and throat): hearing loss, tinnitus, abnormal vision, runny nose, sore throat, etc.
; lungs and other respiratory systems: difficulty breathing, shortness of breath, Shortness of breath, hemoptysis, dry cough, mucus coughing, sneezing, etc.
; Digestive system: abdominal pain, constipation, diarrhea, loss of appetite, gastroesophageal reflux, nausea, vomiting, etc.
; Skin: skin allergies, peeling, petechiae, rash, etc.
; neuropsychiatric system: cognitive dysfunction, memory abnormalities, language barriers, nerve paresthesia, sleep, headaches, mood disorders, taste and smell abnormalities, hallucinations and so on
.
duration of symptoms over 35 weeks most of the data shows that the majority (91.
8% ) For patients who have experienced the "long-term COVID-19", their long-term symptoms persist for more than 35 weeks
.
Among the 3762 respondents, 3608 (96%) reported symptoms for more than 90 days; 2454 (65%) had symptoms for at least 6 months, except for 1,075 people who had been ill for less than 6 months at the time of the survey, only 233 people (6.
2%) recovered within 6 months
.
In terms of severity, the probability of "severe" and "very severe" symptoms peaked during acute infection (<28 days), while the probability of "moderate" and "mild" gradually increased thereafter
.
▲As time goes by, the probability of symptoms of different severity (picture source: reference [1]) is based on the 66 symptoms that the research team has tracked for a long time: among those patients who recovered within 90 days, the average number of symptoms reached the peak in the second week (11.
35 symptoms), and gradually decreased thereafter; while patients who did not recover within 90 days, the average number of symptoms reached a peak in the second month (17.
16 symptoms), and the number of symptoms decreased slowly thereafter, and it is likely that they will still suffer for a longer period of time.
A variety of symptoms are troubled; in patients with symptoms more than 6 months, an average of 13.
8 symptoms appear in the 7th month
.
▲The average number of symptoms reported by different groups of people over time
.
Green-recovery within 90 days, purple-no recovery within 90 days
.
(Image source: Reference [1]) There are many symptoms and a wide range of effects.
Among all 203 symptoms, these patients experienced an average of 55.
9 symptoms, involving 9.
1 organ systems during the "long COVID-19" period
.
Almost all "long-term COVID-19" patients experience systemic (99.
7%) and facial features (100%) symptoms
.
More than 85% of patients with "long new crown" have musculoskeletal, cardiovascular, digestive, pulmonary, and neuropsychiatric symptoms
.
The most common symptoms include fatigue (98.
3%), discomfort after exertion (89.
1%) and cognitive dysfunction (85.
1%)
.
These patients believed that the three symptoms that made them feel weak were fatigue (2652 people, 70.
5%), breathing problems (2242 people, 59.
6%), and cognitive dysfunction (1274 people, 33.
9%)
.
Image source: 123RF relapses frequently and recovery is difficult.
85.
9% of patients experienced recurrence of symptoms.
The main predisposing factors were physical activity (70.
7%), stress (58.
9%), exercise (54.
39%) or mental activity (46.
2%)
.
Among patients whose symptoms persisted for more than 6 months, more than 50% had the following symptoms: fatigue (80%), discomfort after exertion (73.
3%), cognitive dysfunction (58.
4%), sensory motor symptoms (55.
7%), Headache (53.
6%) and memory problems (51%)
.
In addition, 30%-50% of patients will also experience the following symptoms: insomnia, heart palpitations, muscle aches, shortness of breath, dizziness and balance problems, sleep and language problems, joint pain, tachycardia, and other sleep problems
.
Dr.
Akrami specifically emphasized, “Memory and cognitive dysfunction are the most common and long-lasting neurological symptoms, which are equally common at all ages and have a significant impact on work
.
Other symptoms are also common, which may indicate the central nervous system.
There are extensive problems with the peripheral nervous system
.
"These symptoms of the "long-term new crown" have seriously affected the work of the patient
.
Compared with before the illness, only 27.
3% of the patients had no change in their working hours, 45.
2% of the "long COVID-19" patients shortened their working hours, and 22.
3% were unable to work due to illness when participating in the survey
.
Picture source: The 123RF paper pointed out that 7 months after the onset, there are still many patients who have not recovered.
They are mainly affected by systemic symptoms and neurological/cognitive symptoms.
They have not returned to their previous work levels and continue to suffer serious Symptom burden
.
The research team stated that the research has its limitations.
For example, retrospective research is affected by patient recall bias; research is distributed through patient organizations, which generally provide assistance to patients with “long-term COVID-19,” which may lead to sampling bias; population diversity is limited, Most of the included patients were English-speaking patients
.
However, other studies have also shown that about one-seventh of new crown patients still have symptoms at 12 weeks, and the number of "long-term new crown" patients may be very large
.
But overall, Dr.
Akrami pointed out: “This study reveals for the first time that a wide range of symptoms, especially neurological symptoms, are common and persistent in patients with'long-term new crown'
.
” At present, relevant clinical guidelines are effective for long-term recovery of patients with new crown.
The guidance mainly focuses on cardiovascular and respiratory function tests.
The research team recommends that the evaluation scope of the "long new crown" be further expanded to include symptoms of mental, neurological and activity intolerance
.
