Post–COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients, 2022, Fernandez-de-las-penas et al

Key Points

Question What is the prevalence of post–COVID-19 symptoms among hospitalized and nonhospitalized patients 2 years after acute infection?

Findings This cross-sectional study found that the proportion of patients with at least 1 post–COVID-19 symptom 2 years after acute infection was 59.7% for hospitalized patients and 67.5% for those not requiring hospitalization. No significant differences in post–COVID-19 symptoms were seen between hospitalized and nonhospitalized patients.

Meaning Similar rates of post–COVID-19 symptoms between hospitalized and nonhospitalized patients suggest that, among all patients who contract COVID-19, these sequelae deserve attention.

Abstract
Importance Identification of long-term post–COVID-19 symptoms among hospitalized and nonhospitalized patients is needed.

Objective To compare the presence of post–COVID-19 symptoms 2 years after acute SARS-CoV-2 infection between hospitalized and nonhospitalized patients.

Design, Setting, and Participants A cross-sectional cohort study was conducted at 2 urban hospitals and general practitioner centers from March 20 to April 30, 2020, among 360 hospitalized patients and 308 nonhospitalized patients with acute SARS-CoV-2 infection during the first wave of the pandemic. Follow-up was conducted 2 years later.

Main Outcomes and Measures Participants were scheduled for a telephone interview 2 years after acute infection. The presence of post–COVID-19 symptoms was systematically assessed, with particular attention to symptoms starting after infection. Hospitalization and clinical data were collected from medical records. Between-group comparisons and multivariate logistic regressions were conducted.

Results A total of 360 hospitalized patients (162 women [45.0%]; mean [SD] age, 60.7 [16.1] years) and 308 nonhospitalized patients (183 women [59.4%]; mean [SD] age, 56.7 [14.7] years) were included.

Dyspnea was more prevalent at the onset of illness among hospitalized than among nonhospitalized patients (112 [31.1%] vs 36 [11.7%]; P < .001), whereas anosmia was more prevalent among nonhospitalized than among hospitalized patients (66 [21.4%] vs 36 [10.0%]; P = .003).

Hospitalized patients were assessed at a mean (SD) of 23.8 (0.6) months after hospital discharge, and nonhospitalized patients were assessed at a mean (SD) of 23.4 (0.7) months after the onset of symptoms.

The number of patients who exhibited at least 1 post–COVID-19 symptom 2 years after infection was 215 (59.7%) among hospitalized patients and 208 (67.5%) among nonhospitalized patients (P = .01).

Among hospitalized and nonhospitalized patients, fatigue (161 [44.7%] vs 147 [47.7%]), pain (129 [35.8%] vs 92 [29.9%]), and memory loss (72 [20.0%] vs 49 [15.9%]) were the most prevalent post–COVID-19 symptoms 2 years after SARS-CoV-2 infection.

No significant differences in post–COVID-19 symptoms were observed between hospitalized and nonhospitalized patients.

The number of preexisting medical comorbidities was associated with post–COVID-19 fatigue (odds ratio [OR], 1.93; 95% CI, 1.09-3.42; P = .02) and dyspnea (OR, 1.91; 95% CI, 1.04-3.48; P = .03) among hospitalized patients.

The number of preexisting medical comorbidities (OR, 3.75; 95% CI, 1.67-8.42; P = .001) and the number of symptoms at the onset of illness (OR, 3.84; 95% CI, 1.33-11.05; P = .01) were associated with post–COVID-19 fatigue among nonhospitalized patients.

Conclusions and Relevance
This cross-sectional study suggested the presence of at least 1 post–COVID-19 symptom in 59.7% of hospitalized patients and 67.5% of nonhospitalized patients 2 years after infection.

Small differences in symptoms at onset of COVID-19 were identified between hospitalized and nonhospitalized patients. Post–COVID-19 symptoms were similar between hospitalized and nonhospitalized patients; however, lack of inclusion of uninfected controls limits the ability to assess the association of SARS-CoV-2 infection with overall and specific post–COVID-19 symptoms 2 years after acute infection.
Future studies should include uninfected control populations

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798446

 

expert reaction to study looking at post–COVID-19 symptoms 2 years after SARS-CoV-2 infection

A study published in JAMA Network Open looks at post–COVID-19 symptoms 2 years after SARS-CoV-2 infection among hospitalised vs non-hospitalised patients.

Prof Fergus Gleeson, Professor of Radiology, University of Oxford, said:

“I think this paper offers some hope to the Post COVID community, in that some of their symptoms do appear to improve over time. Ourselves and others are currently working with participants suffering from Long COVID, with trials funded by the NIHR to help determine the cause of their ongoing symptoms, and will also be able to report back on the change they experience over time.”

Prof Daniel Altmann, Professor of Immunology, Imperial College London, said:

“This Spanish study conducted phone interviews with people aged around 60 who’d had Covid-19 during the first wave. They compared those who’d been hospitalised with those who were not, asking them at 2-years if they still had symptoms. They came up with high numbers – 60% in the hospitalised group, about 68% in the non-hospitalised group.

So if we extrapolated this to chances of Long Covid in all who have ever had COVID-19, the numbers would be huge, far worse than any of us anticipated up to now. We should certainly find this scary.

However, there are a few points to bear in mind: over 60s aren’t necessarily representative of the effects across all ages ranges, these were ‘first-wavers’ who got infected in that awful period before there was any protection from vaccines, and during the first wave the distinction between ‘hospitalised’ and ‘at home’ could sometimes be nuanced – that is, many forced to stay home were actually extremely unwell.

A good way to think about the impact of these huge numbers is to consider the relationship to the ONS-reported Long Covid numbers in the UK. We have a vast number with persistent symptoms, hovering above 2-million defined as Long Covid, but this covers a range of severity with a devastating 340,000 significantly disabled and finding it hard to function as before.

All in all, I take a study such as this one from Spain to mean we may have been under-counting Long Covid. For every person who struggles to see a GP and maybe get a referral to Long Covid clinic, how many are there who saw no point, or just brushed their new symptoms aside with a bit of ‘ah well, we’re none of us getting any younger.

Counted or not, the long-term impact on our health, our workforce, our economy, our quality of life will be huge for some years to come.”

https://www.sciencemediacentre.org/...-symptoms-2-years-after-sars-cov-2-infection/

 

This is really a shocking comment when you think about it. The starting position for all of this was: absolutely not, this is not a thing, no one will have any long-term consequences unless they suffer from severe disease and anyone who says otherwise is a crank trying to incite panic.

And now we have basically confirmation that there aren't large or significant differences between mild and severe illness in terms of impact on functioning, a number that is huge because, as a result of a policy of constant mass re-infections, the denominator is for the whole population.

It's also been known for 2 years that most people recover with time, clearly something significant if anyone cared to research it, so this cannot be "good news" as it's not even news. This is like finding out something and somehow actually believing that no one knew this information before. Or whatever. All of which means that all the claims about treatments and rehabilitation are invalid, except those two facts are never reconciled, they exist in different parallel universes, or something.

It's especially shocking because of the combination of lack of treatments and widespread apathy, two sides of the same coin. It amounts to millions of disabled people who have been disrespected from the start, adding on to tens of millions before, who have lost so much already, from a starting point where this was so never going to happen at all that even suggesting it was considered silly...

and this dude is like "good news". WTAF? This is genuinely as completely detached from reality as the most privileged aristocrat ever was. "Let them have a freaking puppet theater show, for all I care, which I do not, just to be very clear about what I mean here".

 

Pulse website covering the study

Over two thirds of first-wave Covid infections led to long Covid, finds study

Over two-thirds of non-hospitalised patients infected with Covid in the first wave of the pandemic developed long Covid, according to a new study.

In the first study to directly compare patients who were hospitalised or well enough to remain at home, researchers found fatigue to be the most long-lasting and prevalent symptom.

The study of more than 650 patients in Spain found that 59.7% of hospitalised patients and 67.5% of non-hospitalised patients had at least one post-Covid-19 symptom two years later.

While this was in a non-vaccinated population who were infected with the initial strain of Covid-19 it supports the hypothesis that severity of initial infection is not a risk factor for long Covid, they said.

But they said the prevalence of breathlessness two years after infection was small in both groups, even though a more common symptom in hospital patients initially, and had decreased as time passed.

Writing in JAMA Network Open, the researchers concluded: ‘Current evidence supports that long Covid will require specific management attention independently of whether the patient has been hospitalised or not.’

The latest figures from the Office for National Statistics on long Covid published earlier this month show an estimated 2.1 million people or 3.3% of the population experiencing self-reported long Covid symptoms that have lasted more than four weeks.

Of those, 507,000 had a Covid infection more than two years ago and 333,000 say their ability to undertake their day-to-day activities has been limited a lot.

Professor Fergus Gleeson, professor of radiology at the University of Oxford who is currently one of those doing government-funded trials on long Covid said: ‘I think this paper offers some hope to the post Covid community, in that some of their symptoms do appear to improve over time.’

Professor Daniel Altmann, professor of immunology at Imperial College London, said if the figures found in the study were extrapolated to all Covid patients the numbers would be huge and it was important to remember that those infected at the start of the pandemic were in a different situation when many who were forced to stay at home were actually very unwell.

But he added the study suggests we could have been ‘undercounting’ long Covid.

‘For every person who struggles to see a GP and maybe get a referral to long Covid clinic, how many are there who saw no point, or just brushed their new symptoms aside with a bit of “ah well, we’re none of us getting any younger”.

‘Counted or not, the long-term impact on our health, our workforce, our economy, our quality of life will be huge for some years to come,’ he added.

https://www.pulsetoday.co.uk/news/c...vid-infections-led-to-long-covid-finds-study/

 

Oh wow. The big guns are coming out, folks. We, OK some in the UK, depending on territory and other arbitrary factors, may, just may, soon, OK soon-ish, get some "specific management attention", and maybe some more MBA management buzzwords, too. You know how long we've been begging for attention so this is basically it, we made it!

Can you feel it? That's basically the same as a effective medical care. Or something. Hard at work? Ha, hardly working at it.

Pretty remarkable that they either don't see or aren't bothered by the opposite of that:

Because the far more common scenario is patient who went to see GP and was brushed off with nonsense like that, or worse. Or couldn't even see one. Or were too ill with no accommodations. But they are self-faults and they either can't see or acknowledge those, with the same outcome.

 

When these GPs are finally "retrained" they ought to be forced to go back through all the patients they fobbed off and contact them, admit they messed up and then refer them. It wont happen, there is zero chance you can get a GP to admit fault but its what a functioning healthcare system would do if it found it had misdiagnosed 2 million people.

 

Post-Covid. Have they demonstrated that persistently? That the virus is gone from every possible repository in a person?

If they admit Covid can exist in priviledged sites, then it leaves the entire profession exposed to similar conclusions about other pathogens. There are too many horses in that race to allow that to happen.

 

Something I think about often. There will be a need for outreach programs, even if there is a breakthrough, so many will not hear of it and likely have stopped contacting healthcare services entirely. Even then I don't doubt that many physicians will reject it entirely, this will need a systemic approach that bypasses the obstructionists.

The real work will begin at this point, decades of lies that added up a massive debt to the truth, all of this will need to be accounted for. We will need to figure out what happened, what's on record, who is to blame, and so on.

But it can't even begin yet. Because of 19th century myths. Pffft.

 

In a fantasy world where Ron Davis' Itoconate drugs are genuinely the cure and we know about it in the next months my first thought is where I will likely buy this from abroad. My instinct would not be to go to my GP, they will take years to decades to accept the reality of the treatment by which point I will have spent a decade being well. I don't have to try and fight to first get a diagnosis and then to fight for a treatment that the NHS will take a decade fighting against giving us. Why submit to that abuse when it will achieve nothing of use but being subjected to more dehumanising nonsense.

I suspect this is how it will play out for most ME sufferers, they will travel abroad or import what we need as the rest of the world adopts treatments. The NHS will keep on using CBT and refusing to diagnose 90% of the sufferers. Its positively medieval with a giant wallop of not invented here syndrome added in.