It’s been over two years since SARS-CoV-2 first emerged. I don’t know about you, but my 2020 did not look anything like I had planned. And even in that chaotic time, I certainly never thought that I would be researching and writing a blog post about this in July, 2022. But here we are…
I’m not going to bury the lead. I can’t answer either of the questions posed in the title of this post. Even though it feels like a lifetime since we entered the global pandemic, in the grand scheme of research studies, two years is actually a quick turn around to complete research, analyze the data, and get it published. So unfortunately, we are still very much in the dark about the effects of COVID-19. However, given the global need for this information, scientists have been able to fast track some research so that we can start to more fully understand this virus.
As a cognitive therapist, I have seen an increasing number of patients who are suffering from what has been termed “long-COVID” symptoms. Based on my own (completely unscientific) analysis, there is not a single link that would determine why they all suffer from extended symptoms. They are varying ages, both male and female, have differing occupations and educational levels, etc. Some have significant prior medical issues, and some were healthy with no complaints. So, I turned to the research to see if the people who actually get paid to study this stuff came up with anything better. Here’s what I’ve got for you:
I’ve already mentioned that there aren’t many answers yet, but on a positive note, there is a significant amount of research happening on this topic. I chose to use a scientific article from BMJ Global Health that was published in September, 2021. The authors consider it a “living” systematic review (LSR).
[Sciency side note: A typical systematic review takes multiple articles that meet specific criteria and analyzes/summarizes them all in one place. Given the frequency of new research that is presented on COVID-19, they created the “living” review in order to add updated information as it gets published. For this particular review, they plan to update it every 6 months for up to two years.]
This LSR included thirty-nine studies, which among other criteria all had at least 100 participants and included those who had symptoms at least 12 weeks after the initial onset of the illness. In order to avoid boring you with the details, here are the major takeaways:
-Categories for symptoms included systemic (e.g., fatigue, weakness), cardiopulmonary (e.g., cough, chest pain), upper respiratory (e.g., sore throat, nasal congestion), gastrointestinal (e.g., nausea/vomiting, loss of appetite), musculoskeletal (e.g., pain), neurological and neuromuscular (e.g., headaches, taste and smell changes), psychological and social (e.g., depression, sleep disorder), neurocognitive (e.g., memory impairment, confusion), and other (e.g., skin rash, hair loss).
-The most common (at least 25% of the participants reported having these) persisting symptoms reported were marked fatigue, weakness, general malaise, breathlessness, and concentration impairment lasting for a prolonged period of time.
-The lesser prevalent (i.e., secondary) symptoms are extremely diverse (see categories above). If you really want the full list, please refer to Figure 3 on page 8 of the LSR.
-Long-COVID affects both hospitalized and non-hospitalized patients. This review did not find any specific characteristics that they could “confidently conclude” would lead to a higher risk factor across the studies.
-Limitations to current (and future) research include no standardized and validated test/tools on this novel virus, as well as the massive variations in both the long-COVID population and the symptoms reported.
You may be asking yourself, “What’s the point then?” This clearly is an issue that is affecting many people- some research has shown that 1 in 10 people have symptoms persisting after 12 weeks. As more data is collected and analyzed, future research studies can become more specific in what they are looking for. Then, treatment options can be assessed as well.
If you are reading this and dealing with long-COVID, or know someone who has long-COVID, please consider participating in a research study. There are many options, ranging from quick surveys to more involved medical research. Here are two good places to start looking:
https://www.niaid.nih.gov/clinical-trials/covid-19-clinical-trials
https://clinicalcenter.nih.gov/recruit/search/covidsearch.html
Also, you are not alone and there are many support groups available. Here is a list of long-COVID support groups (by country):
https://www.longcovid.org/images/Documents/List_of_support_groups_by_country.pdf
Michelen M, Manoharan L, Elkheir N, et alCharacterising long COVID: a living systematic reviewBMJ Global Health 2021;6:e005427.