“This is a more well-conducted population-level study that suggests we should be very concerned about the current number of acute infections,” said David Putrino, director of rehabilitation innovation at Mount Sinai Health System in New York. “We’re in trouble.”
Jill Pell, a professor of public health at the University of Glasgow who led the research, stressed that the study revealed the wide-ranging impact of the new coronavirus on people’s lives in the long term. “There are many different impacts beyond health, affecting quality of life, employment, education and the ability to take care of yourself,” she said.
The paper, published Wednesday in Nature Communications, represents the first findings of an ongoing lung covid study – the Long-CISS (Scottish Covid Study).
The range of symptoms reported and the inability to provide a prognosis for patients has long puzzled researchers, even as the breadth of the challenge has become clearer. According to government estimates, 7 million to 23 million Americans — including 1 million who can no longer work — are suffering from the long-term effects of the virus. Those numbers are expected to rise as the coronavirus becomes endemic.
Previous studies have been challenged by the nonspecific nature of long-term coronavirus symptoms, including dyspnea and fatigue, which are also common in the general population. Pell said the Scottish coronavirus study, which included a control group, was able to pinpoint which symptoms were linked to the virus.
“Those with Covid-19 were more likely to have 24 of the 26 symptoms studied compared to the general population who had never been infected,” she said. For example, those who were infected were more likely to have difficulty breathing 3.5 times higher.
Putrino noted that 16 to 31 percent of the control group also developed the same symptoms — a figure similar to the false-negative rate of PCR tests, suggesting that some of the control group may have been infected. Pell agreed that some of those who tested negative may have been infected, helping to strengthen the study’s broader findings.
Symptoms in long-haul transporters vary from person to person. In the Scottish study, the most common symptoms included dyspnea, palpitations, chest pain and “brain fog” or decreased mental acuity.
Symptoms are worst in people who are sick enough to require hospitalization during an acute infection — a fact that doesn’t help to assuage experts’ concerns.
“All the time, people who are sicker are more likely to have long-term sequelae,” Putrino said. “The scary thing is that mild cases far outnumber severe cases, so even a small fraction of mild cases that go on to develop long-term sequelae is a huge public health problem.”
Putrino also cautioned against assuming that asymptomatic infection is not associated with persistent symptoms.
“We’ve seen many patients with confirmed asymptomatic cases,” he said. “It happens. Statistically, it’s less common than those with symptoms.”
Women, older adults and people living in economically disadvantaged communities are at greater risk of developing lung disease, the study found. People who already suffer from physical and mental health problems such as respiratory illness and depression are also more likely to develop chronic Covid-19.
“Critically, this study also identified an 11% subgroup that deteriorated over time. This is something that is often seen in patient populations but not discussed enough in the public conversation,” Hannah Davis, a member of the Patient-Led Research Collaborative, a group of patients who have long been involved in Covid-19 research.
While the study didn’t find any particular surprises, its nationwide design offers a new level of rigor, Pell said. More than 33,000 laboratory-confirmed infected persons and 62,957 uninfected persons participated in the event.
Throughout the pandemic, U.S. experts, including the president’s chief medical adviser Anthony Fauci, have often turned to Britain’s data because it From a nationalized health system, reflecting trends across the population.
Using National Health Service records, the researchers sent a text message to every Scottish adult who tested positive for PCR, as well as a group of people who tested negative for Covid-19, inviting them to participate. Those who chose to sign up answered online survey questions about their health before and after infection.
“Being able to get survey data from a large cohort is very powerful,” said James Harker, an immunologist at Imperial College London who studies the long-term effects of the coronavirus on the lungs. Harker said the U.S. study was largely Having to rely on smaller numbers or using several studies to perform a meta-analysis is inherently flawed.
One of the questions that deserves more exploration, Putrino believes, is the degree of protection that vaccination provides. Recent studies have shown that vaccination can reduce the chances of getting pulmonary covid, but not as much as previously thought.
“That’s one of the most important things we need to know next,” Putrino said.
The University of Glasgow team, led by Pell, is working with Public Health Scotland, the National Health Service Scotland, and the Universities of Aberdeen and Edinburgh, and is funded by the Scottish Government’s Office of the Chief Scientist and Public Health Scotland.
Researchers According to Pell, additional research is planned. The current study followed people 6, 12 and 18 months after infection. Of those diagnosed with Covid-19, 13% reported some improvement.
“We’re trying to look in more detail at how these symptoms change over time and the factors associated with them,” Pell said.