Trial Report “The burden of post-acute COVID-19 symptoms in a multinational network cohort analysis”, 2023, Kostka et al.

“The burden of post-acute COVID-19 symptoms in a multinational network cohort analysis”
Kostka, Kristin; Roel, Elena; Trinh, Nhung T. H.; Mercadé-Besora, Núria; Delmestri, Antonella; Mateu, Lourdes; Paredes, Roger; Duarte-Salles, Talita; Prieto-Alhambra, Daniel; Català, Martí; Jödicke, Annika M.

Persistent symptoms following the acute phase of COVID-19 present a major burden to both the affected and the wider community.

We conducted a cohort study including over 856,840 first COVID-19 cases, 72,422 re-infections and more than 3.1 million first negative-test controls from primary care electronic health records from Spain and the UK (Sept 2020 to Jan 2022 (UK)/March 2022 (Spain)). We characterised post-acute COVID-19 symptoms and identified key symptoms associated with persistent disease. We estimated incidence rates of persisting symptoms in the general population and among COVID-19 patients over time. Subsequently, we investigated which WHO-listed symptoms were particularly differential by comparing their frequency in COVID-19 cases vs. matched test-negative controls. Lastly, we compared persistent symptoms after first infections vs. reinfections.

Our study shows that the proportion of COVID-19 cases affected by persistent post-acute COVID-19 symptoms declined over the study period. Risk for altered smell/taste was consistently higher in patients with COVID-19 vs test-negative controls. Persistent symptoms were more common after reinfection than following a first infection.

More research is needed into the definition of long COVID, and the effect of interventions to minimise the risk and impact of persistent symptoms.

Link | PDF (Nature Communications)

 

I agree. Counting symptoms is hopeless.
I would have thought it more useful to go for something like newly being off work from time of Covid without other explanation.

 

Thanks Hutan - if you, or anyone else, is aware of a:

• "good epidemiological studies of Long Covid/PCS";
• "Can anyone recall a good large study of incidence?"

then I'd be interested.

@ME/CFS Skeptic

 

I think, at the moment, the one by Rosmalen and her Lifelines cohort is one of the best, unfortunately.
Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study - The Lancet

Still haven't seen a good epidemiological study that tested for ME/CFS following COVID-19, unless I overlooked?

 

This kind of objective outcome needs to be more prevalent in a lot of research. We need to see it more often in ME research too.

 

I keep thinking about this. It might be urgently needed, we wont know until after it happens and we see the data. Given the incidence of infection and re-infection that we know of, planning future studiers and public health options may require this.

As a guesstimate, not nearly reliable, I suspect that the new prevalence of ME may approach 3% over time, with perhaps 10% as a ceiling. I really hope this is not the case, and we need good epidemiology to figure it out. I do think there are probably two categories of post COVID, one with ME and one without. I also think the sometimes prevalence in some studies of 6-7% may be highly misleading. A good percentage of these patients is likely to be from prolonged recovery from all the damage COVID did, not ME.

 

You'd need a reliable way to measure ME/CFS pre & post covid - essentially biomarkers?

 

Yes, this one is definitely hopeless. If you look at their risk ratios, it's pretty clear that there is some kind of selection problem with their infected versus negative cohorts. Sure looks like the infected cohort is somehow healthier and having fewer symptoms than the negative cohort (aside from the altered smell or taste):


I doubt their claim about the risk of symptoms being higher after reinfections is meaningful in this context.