The health impact of long COVID during the 2021–2022 Omicron wave in Australia: a quantitative burden of disease study 2023 Howe et al

Background
Long COVID symptoms occur for a proportion of acute COVID-19 survivors, with reduced risk among the vaccinated and for Omicron compared with Delta variant infections. The health loss attributed to pre-Omicron long COVID has previously been estimated using only a few major symptoms.

Methods
The years lived with disability (YLDs) due to long COVID in Australia during the 2021–22 Omicron BA.1/BA.2 wave were calculated using inputs from previously published case-control, cross-sectional or cohort studies examining the prevalence and duration of individual long COVID symptoms. This estimated health loss was compared with acute SARS-CoV-2 infection YLDs and years of life lost (YLLs) from SARS-CoV-2. The sum of these three components equals COVID-19 disability-adjusted life years (DALYs); this was compared with DALYs from other diseases.

Results
A total of 5200 [95% uncertainty interval (UI) 2200–8300] YLDs were attributable to long COVID and 1800 (95% UI 1100-2600) to acute SARS-CoV-2 infection, suggesting long COVID caused 74% of the overall YLDs from SARS-CoV-2 infections in the BA.1/BA.2 wave. Total DALYs attributable to SARS-CoV-2 were 50 900 (95% UI 21 000-80 900), 2.4% of expected DALYs for all diseases in the same period.

Conclusion
This study provides a comprehensive approach to estimating the morbidity due to long COVID. Improved data on long COVID symptoms will improve the accuracy of these estimates. As data accumulate on SARS-CoV-2 infection sequelae (e.g. increased cardiovascular disease rates), total health loss is likely to be higher than estimated in this study. Nevertheless, this study demonstrates that long COVID requires consideration in pandemic policy planning, given it is responsible for the majority of direct SARS-CoV-2 morbidity, including during an Omicron wave in a highly vaccinated population.

Open access, https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyad033/7100842

 

Fantasy numbers. It's been 3 years, all it would take to reach this is 2600 patients with LC the whole time. They seem to be using study cut-off points, so a study after 2 years that reported symptoms after 3 months would only count for 3 months.

They decided to use 55% ratio for vaccinated cases, so some numbers are multiplied by unreliable estimates. So at best an estimate calculated out of guesstimates and incomplete data. A problem here is the definition of disability, which we know is largely rejected when there is no technological of social validation for why the patient is unable to function.

They seemed to have merely taken an estimate based on presence of symptoms and some arbitrary disability burden (as if the disability burden of fatigue or pain are properly accounted for):

So it's not actual disability, but an estimate of what the disability may be based on what symptoms have been recorded. Of course there is no data anywhere on duration of symptoms for patients, all studies have cut-off points and there is no tracking.