Temporal trajectories of COVID-19 symptoms in adults with 22 months follow-up in a prospective cohort study in Norway, 2024, Merete Ellingjord-Dale

Abstract
Objectives We aimed to describe the trajectories of cognitive and physical symptoms before, during, and after a positive- or negative SARS-CoV-2 test and in untested controls. Design A prospective cohort study.

Setting Norway, 27 March 2020 to 6 July 2022 Participants A total of 146 065 volunteers were recruited. Of these, 120 605 participants (mean age 49 (SD 13.7), 69% female), were initially untested for the SARS-CoV-2 virus, completed one or more follow-up questionnaires (response rates 72-90%) and were included for analysis. After 22 months of follow-up, 15 737 participants had a positive SARS-CoV-2 test, 67 305 a negative test, and 37 563 were still untested.

Main outcome measures We assessed reported symptoms the past three weeks of memory or concentration problems, anosmia and dysgeusia, dyspnoea, fatigue, fever, headache, cough, muscular pain, nasal symptoms, sore throat and abdominal pain at baseline and through four follow-up questionnaires. In addition, overall health compared to a year before was measured with a five-point scale and memory problems were measured using the Everyday Memory Questionnaire-13 at two timepoints.

The exposure, SARS-CoV-2 test status (positive, negative or untested), was obtained from a mandatory national registry or from self-report, and data were analysed using mixed model logistic regression.

Results A positive SARS-CoV-2-test was associated with the following persistent symptoms, compared with participants with a negative test (1-3 months after a negative test); memory problems (3 to 6 months after a positive test: adjusted odds ratio (OR) 9.1, 95% confidence interval (CI) 7.5 to 10.9; 12 to 18 months: OR 7.8, CI 5.7 to 10.8), concentration problems (3 to 6 months: OR 6.1, CI 4.8 to 6.5; 12 to 18 months: OR 5.3, CI 3.9 to 7.1), anosmia and dysgeusia, dyspnoea and fatigue as well as self-assessed worsening of overall health.

Conclusion A positive SARS-CoV-2 test was associated with new onset memory- and concentration problems, anosmia and dysgeusia, dyspnoea and fatigue as well as self-assessed worsening of overall health, which persisted for the length of the follow-up of 22 months, even when correcting for symptoms before COVID-19 and compared to symptoms in negative controls.

https://www.medrxiv.org/content/10.1101/2024.04.30.24306604v1

 

They basically excluded many of the most typical symptoms, so not a great study by any means:

Not known to them, I guess. It's so hard to, like, read and pay attention to stuff. Like, who has time to read the first studies that came out and established the very concept, when you're busy doing your own study with your own ideas from inside your own head? Or literature on this issue dating back decades. Who has time for this stuff?! It's not like it's their job, or something like that. Wow that would be so embarrassing.

Some of those are a bit weird, including increases in symptoms from controls, which suggests that there were issues with controls, understandable when a policy of constant mass reinfections is pursued:


Red is "Tested positive", blue is "Tested negative", dotted line is not tested.

We can clearly see from bumps in symptoms that many who tested negative (in blue) clearly got COVID. So the variations are definitely underestimated, and that's with ignoring many of the common symptoms, including the most disabling ones.

But one thing this does indicate is that viral load as detectable by a RAT is a relatively good predictor of odds of Long Covid. Even though when we look at some symptom profiles, in the case of sore throat and nasal symptoms, they cross over and the "tested negative" are actually more likely to report over time.

We really need more substantial data about symptoms over time, it's likely to be significant. The very first study by Body Politic remains the best to this date on this front. What a shameful embarrassment, that an entire industry of well-funded professionals still can't do better than a bunch of sick amateurs.

 

Just to make it clear, from watching the man heading this team debating LC in various news channels: he is well up to date at this point in time. Publications will catch up. He takes the problem very serious, and recognizes both the burden on patients and society of not tackling LC (and ME). He’s been quite vocal on this issue, and a voice of reason for LC patients in Norway. I understand the framing though, from an empirical perspective

 

OK that's great. It'd still be better if they could adjust the studies when new information comes in, but for sure many did start knowing nothing and things tend to be set in stone after a point. Academia, pffft.