Long-term covid has many more symptoms than previously believed, British researchers write in Nature Medicine. They suspect that the term also conceals several disorders.
Many reported symptoms of long-term covid, such as fatigue and shortness of breath, have a significant effect on people’s daily activities, quality of life and work performance. But long-term covid symptoms are much broader. In a new study in Nature MedicineBritish researchers identified 62 symptoms associated with long-term covid.
The first long-term covid-19 study focused mainly on people who had been hospitalized. But most covid patients have been treated in primary care. As a result, we know relatively little about long-term covid in people with usually milder initial infections.
In the study, the researchers analyzed primary care records of more than 450,000 people in Britain with a confirmed diagnosis of Covid. They compared these with similar records of 1.9 million people without a covid history and looked specifically at 115 different complaints at the general practitioner. For those who had covid, that happened at least three months after the initial covid diagnosis.
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They found that people diagnosed with covid were significantly more likely to report 62 symptoms, of which only 20 are listed in the official WHO definition for long-term covid.
Some of those symptoms were to be expected, such as loss of sense of smell, shortness of breath and fatigue. But others are surprising and less well-known, such as hair loss and decreased libido. Still other symptoms include chest pain, fever, erectile dysfunction, and swelling of limbs.
The differences in symptoms between the infected and non-infected groups persisted even after taking into account age, gender, ethnic group, socioeconomic status, body mass index (BMI), smoking behavior or the presence of more than 80 health problems.
The researchers also found that factors such as lower age, female gender, and being part of certain ethnic minority groups increase the likelihood that patients will report such symptoms of lung covid. So are lower socioeconomic status, smoking, obesity and a wide range of health problems.
Multiple conditions
Given the magnitude and diversity of the reported symptoms, it is unlikely that there is a single condition behind the term “prolonged covid”. Rather, it concerns a group of different disorders that have arisen as a result of a covid infection. Studying the symptoms of long-term covid in different groups could help scientists understand the different disease processes in the body.
This analysis indicates that “lung covid” can be split into three different groups, based on clusters of reported symptoms. The largest group, accounting for about 80 percent of people with long-term covid in the study, experienced a broad spectrum of symptoms, from fatigue to headaches and physical pain. The second largest group—about 15 percent—had mainly psychological and cognitive symptoms, including depression, anxiety and insomnia. The third and smallest group, about 5 percent, had mainly respiratory symptoms such as shortness of breath, coughing and wheezing.
What now?
The researchers were only able to assess symptoms that patients reported during the consultation with their GP. Of course, not everyone reports symptoms to a doctor, so our research is limited to comparing differences in symptoms as reported by people with and without a history of covid. It is also possible that some patients in the control group had covid but were either not tested or did not inform their GP.
Still, the study confirms previous reports about the magnitude and diversity of lung covid symptoms. It also confirms that their symptoms cannot simply be attributed to other factors, such as pre-existing health problems or the effects of stress from living in the pandemic.