One-year temporal changes in long COVID prevalence and characteristics: a systematic review and meta-analysis, 2022, Qiangru Huang, MD et al

[Mij]

A common misconception is that we do not need to focus on LC because most people get well over time. Turns out that this is not true. A new meta-analysis shows that symptoms on average decrease by 50% during the first month but then stabilize.

Highlights

• 1.
  What is already known about this topic?
  • Long COVID shows multiorgan symptoms and persists for a long period in some post-acute patients.
• 2.
  What does the paper add to existing knowledge?
  • Our findings highlight the temporal change in prevalence of 44 specific long COVID symptoms. About two-thirds of the symptoms did not reduce during the 1-year follow-up. The influence of acute phase-related factors for long COVID gradually decreases over time.
• 3.
  What insights does the paper provide for informing health care-related decision making?
  • Long COVID may persist longer than expected and more attention should be paid to neuropsychiatric symptoms.

Abstract
Objectives
This study aimed to explore the 1-year temporal change in prevalence, variety, and potential risk factors of long COVID symptoms, and to further predict the prognostic trends of long COVID.
Methods
We searched electronic databases for related studies published from January 2020 to February 2022, and conducted one group meta-analysis and locally weighted regression explore the monthly temporal change in the prevalence of each long COVID symptom in 1-year follow-up period.
Results
A total of 137 studies were included in meta-analysis, including 134,093 participants. The temporal change of any long COVID symptom showed a steep decrease initially (from 92% at acute phase to 55% at 1-month follow-up), followed by stabilization at approximately 50% during 1-year follow-up. Six months or more after the acute phase, the odds ratio (OR) of population characteristic factors increased, such as female gender (from 1.62 to 1.82), while the OR value of acute phase-related factors (severe/critical and hospitalization) decreased. As for specific symptoms, about two-thirds of the symptoms did not significantly reduce during the 1-year follow-up, and the neuropsychiatric symptoms showed a higher long-term prevalence (approximately 25%) and longer persistence than physical-symptoms.
Conclusions
The temporal changes in the prevalence and characteristics speculate that long COVID may persist longer than expected. In particular, we should pay more attention to neuropsychiatric symptoms and other symptoms for which there is no significant downward trend in prevalence. The influence of acute phase-related factors for long COVID gradually decreases over time, while the influence of population characteristic-related gradually increases.

https://www.valueinhealthjournal.com/article/S1098-3015(22)04743-X/fulltext

 

[rvallee]

A common misconception is that we do not need to focus on LC because most people get well over time

Even the premise of this is flawed. Even if 100% recovered, it's clear that many are ill beyond a year. Doing nothing to help people who are ill, literally denying their illness and all that derives from that, is bad in itself. How is that not completely obvious? Especially on a rolling basis that is not about to end and in such large numbers. It's completely flawed thinking.

This is basically how "first do no harm" has been operationalized. This is not at all what it's supposed to be about, it's a complete perversion of this principle when the entire social safety net depends on the medical profession to determine who is ill, and so deserving of support, and who isn't. If medicine is derelict in deciding this, then the whole system is built on a lie. Of course trying dangerous things is not advised, but to categorically refuse to even pay attention is a completely different thing. Knowing more is always better, even if that knowledge is not immediately operationalized. What an absurd system whose starting point was that this would never happen, a failure that isn't even acknowledged because there is simply no accountability.

And anyway given the historical precedent, this is as foolish as ignoring every hurricane because they're all different but cause the same common problems. Which is basically the entire reasoning here. There was basically too much warning here, no other disaster has ever had more precise and documented evidence before it happened. None.

 

[Sean]

A common misconception is that we do not need to focus on LC because most people get well over time. Turns out that this is not true. A new meta-analysis shows that symptoms on average decrease by 50% during the first month but then stabilize.

Which is consistent with patients starting to accept and learn how to better manage their newly acquired opaque and difficult physical limitations, and all its consequences. Because there sure as hell is no effective treatment available.

As for specific symptoms, about two-thirds of the symptoms did not significantly reduce during the 1-year follow-up, and the neuropsychiatric symptoms showed a higher long-term prevalence (approximately 25%) and longer persistence than physical-symptoms.

Which would be consistent with it being a high burden disease, compounded seriously by poor understanding and management by the medical profession and governments, little or no support, and some very nasty stigma and hostility to contend with.

All of which is why people put in that situation are unhappy, concerned, and getting a bit miffed about it.

So there's that.