Long-term symptom profiles after COVID-19 vs other acute respiratory infections: an analysis of data from the COVIDENCE UK study 2023 Vivaldi et al

Background
Long COVID is a well recognised, if heterogeneous, entity. Acute respiratory infections (ARIs) due to other pathogens may cause long-term symptoms, but few studies compare post-acute sequelae between SARS-CoV-2 and other ARIs. We aimed to compare symptom profiles between people with previous SARS-CoV-2 infection, people with previous non-COVID-19 ARIs, and contemporaneous controls, and to identify clusters of long-term symptoms.

Methods
COVIDENCE UK is a prospective, population-based UK study of ARIs in adults. We analysed data for 16 potential long COVID symptoms and health-related quality of life (HRQoL), reported between January 21 and February 15, 2021, by participants unvaccinated against SARS-CoV-2. We classified participants as having previous SARS-CoV-2 infection or previous non-COVID-19 ARI (≥4 weeks prior) or no reported ARI. We compared symptoms by infection status using logistic and fractional regression, and identified symptom clusters using latent class analysis (LCA). This study is registered with ClinicalTrials.gov, NCT04330599.

Findings
We included 10,171 participants (1311 [12.9%] with SARS-CoV-2 infection, 472 [4.6%] with non-COVID-19 ARI). Both types of infection were associated with increased prevalence/severity of most symptoms and decreased HRQoL compared with no infection. Participants with SARS-CoV-2 infection had increased odds of problems with taste/smell (odds ratio 19.74, 95% CI 10.53–37.00) and lightheadedness or dizziness (1.74, 1.18–2.56) compared with participants with non-COVID-19 ARIs. Separate LCA models identified three symptom severity groups for each infection type. In the most severe groups (representing 22% of participants for both SARS-CoV-2 and non-COVID-19 ARI), SARS-CoV-2 infection presented with a higher probability of problems with taste/smell (probability 0.41 vs 0.04), hair loss (0.25 vs 0.16), unusual sweating (0.38 vs 0.25), unusual racing of the heart (0.43 vs 0.33), and memory problems (0.70 vs 0.55) than non-COVID-19 ARI.

Interpretation
Both SARS-CoV-2 and non-COVID-19 ARIs are associated with a wide range of symptoms more than 4 weeks after the acute infection. Research on post-acute sequelae of ARIs should extend from SARS-CoV-2 to include other pathogens.

Open access, https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00428-5/fulltext

 

'Long colds' are a thing, like Long Covid say experts

""Long colds" can be a thing in the same way that "long Covid" is, with some people experiencing prolonged symptoms after an initial infection, according to a UK study.

Common long cold symptoms included a cough, stomach pain and diarrhoea.

The findings come from 10,171 adults who completed questionnaires.

More work is needed to understand who is at risk, how bad it can be and what can be done about it, experts say."

https://www.bbc.co.uk/news/health-67016985

 

In my eyes this study would only be interesting if they would look at those patients with a low HRQoL (or multiple severe symptoms) multiple months post infections via a follow-up. The common long cold symptoms of cough, stomach pain and diarrhoea 4 weeks out are very uninteresting and mind I say for those with a long illness duration seem pretty irrelevant. Furthermore the sociodemographics are once again focused on the older population (under 30=3.2% and 30–<40=6.4% of the Covid cohort, whilst for example the age group 60–<70 is 34.9% of the Covid cohort). You can't find what you're not looking for.

The study has also been discussed here: https://www.s4me.info/threads/covidence-study.14995/.

 

I don't anticipate long cold symptoms are going to lower your energy/stamina baseline for months and years.

 

Yeah, I don't think physicians are testing all their patient with "cold symptoms" for EBV, HHV6 et in the long term?

I had a sudden vertigo attack, sore ear and throat for 7 months after my sudden viral M.E onset in 1991. I don't think my GP tested me for EBV or any other specific virus. I had 'extremely' elevated anti-thyroid antibodies and was sent for a thyroid scan, the endo told me it was 'viral'.

 

The problem is that the above research doesn't at all even try to look at longlasting Long-Covid or even anything related to ME/CFS (it essentially just looks at predominantly older patients to see whether someone had a cough or something else 4 weeks out). Whether the viruses that causes ME/CFS makes a difference to the disease ME/CFS is probably not possible to judge, but there are definitely viruses that seem to be far more connected to ME/CFS than others. ME/CFS cases doubling during the pandemic in Germany according to Scheibenbogen, as well as historical ME/CFS outbreaks is a good indication that certain viruses seem to cause more cases.

The origin of the specific ME/CFS might not matter for the disease ME/CFS, but declaring long cold symptoms to be just the same and as common as longlasting Long Covid is not backed by any evidence (edit: not that the authors are in any way saying that this is the case).

 

Exactly, that is the point that Trish is making.

Where are they making the claim that the symptoms are the same?

Neither

or

claims that the symptoms are the same.

 

Indeed the authors are not making this claim (I also wasn't trying to suggest that they were even though my post does definitely read that way), but I doubt the media or someone reading an article on it will interpret it that way. The question for me is what is the point of studying this so vaguely with the only data being after 4 weeks post infection?

 

From the discussion section,
"This study also has some limitations. First, we focused on symptoms for each individual at a single timepoint, and thus could not map the change in each participant’s symptoms over time with repeated measures; however, our aim for this study was to provide a descriptive snapshot of the post-COVID-19 symptom burden, and longitudinal analyses are planned for future work."

and this addresses several points made in the this thread,
"Third, we do not have details on the type of respiratory infections experienced by our participants reporting non-COVID-19 ARIs, as these are not routinely tested for in the community, preventing us from determining which ARIs are most likely to cause long-term symptoms. However, the fact that we consistently observed differences between our three infection groups, despite the grouping together of different non-COVID-19 ARIs, shows not only that long-term symptoms can occur after non-COVID-19 ARIs, but that these symptoms differ from long COVID."