The Effects of Long COVID

The authors used a questionnaire to collect in three rural districts data on symptoms and clinical characteristics after COVID-19, with the focus on symptoms after 12 weeks.

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June 27, 2022 — Three articles and an accompanying editorial provide information on the effects ofLong COVIDin theDeutsches Ärzteblatt International’s volume 10, a themed issue on the subject.

Christian Förster and coauthors report data on persistent symptoms afterCOVID-19in their original article (Dtsch Arztebl Int 2022; 119: 167–74). In a population-based cohort study they collected data on the prevalence and on risk factors. The background for this study is the observation that after recovering from infection with COVID-19, many people complain of long-term symptoms. To date, the results of epidemiological studies of this observation vary enormously. The authors used a questionnaire to collect in three rural districts data on symptoms and clinical characteristics after COVID-19, with the focus on symptoms after 12 weeks. They evaluated data from 1450 patients. The prevalence of Post-COVID-19 was 72.6% in people admitted to hospital and 46.2% in those not admitted to hospital. The most common long-term symptoms were fatigue, physical exhaustion, difficulty concentrating, and loss of smell or taste. The patients with Post-COVID-19 perceived their quality of life as notably reduced. The strongest risk factors for Post-COVID-19 were female sex, overall severity of comorbidities, and severity of acute COVID-19. According to the researchers, non-hospitalized patients also often experienced continuing symptoms. In their view, the heterogeneity of the symptoms requires a multidisciplinary, stepwise approach to care. Identifying at-risk patients, they say, is crucial.

Another article on the prevalence of persistent symptoms after COVID-19 is presented byKorbinian Lackermair(Dtsch Arztebl Int 2022;119: 175 - 6)。作者对896名在门诊专门治疗的患者进行了横断面研究。除了确定患病率之外，研究人员还调查了是否较轻的感染会相应地导致较少的持续症状。他们从基于标准化问卷的结构化电话访谈中收集数据。In the study period from March 2020 to February 2021, 1673 patients atDachau medical centertested positive for COVID-19. For 896 patients, the complete follow-up questionnaire was available. The mean follow-up period was 6.9 months, patients’ mean age was 41.7 years. In about half of patients, comorbidities were present. 34% of patients reported persistent symptoms. The authors found that in addition to non-specific symptoms, such as fatigue or headache, typical COVID-19 symptoms—such as loss of smell or taste, or dyspnea—also often persisted. Patients with persistent symptoms were significantly older, more of them were women, and the acute phase was associated with more symptoms.

The case–control study of postacute sequelae of SARS-CoV-2 infection reported byMandy Schulzand coauthors also studied patients treated on an outpatient basis (Dtsch Arztebl Int 2022; 119: 177– 8). The authors aimed to characterize patients with regard to risk factors and use of healthcare services. To this end they used nationwide billing data from statutory health insurance (SHI) providers. They included patients who in the second quarter of 2021 had been coded as ICD-10 U09.9!. This was the case for 160,663 patients. The control group was a random sample of all patients treated in the second quarter of 2021 (n=321,326), which matched in terms of age, sex, and place of residence, and for whom neither a post-COVID code had been issued in 2021 nor confirmed COVID-19 infection (ICD-Code U 07.1!) documented in 2020 and 2021. The group of cases included more women and middle-aged patients than the control group as well as a higher proportion of patients who had been treated by SHI-authorized physicians as early as 2020. Patients with COVID-19 accounted for almost double the number of treatment cases compared to the control group. At least one of the post-COVID-symptoms under study occurred in 61% of the cases and in 33% of the controls. Patients with comorbidities, such as back pain, obesity, adjustment disorders, and somatoform disorders had a greater age-dependent risk for post-COVID-19. In the Post-COVID-19 group, SHI-accredited services were more commonly sought, especially GP consultations, than in the control group.

Tobias Welte(Dtsch Arztebl Int 2022;119: 165-6)的结论是，covid - 19后综合征提出的问题比它提供的答案更多。他对出现COVID-19症状的三组患者进行了区分:作为COVID-19住院患者，并在一定程度上接受了重症监护;患者有许多不同的症状，但在日常生活中并没有严重受损;还有一些患者由于过度疲劳和恢复力不足而无法独立管理日常生活。第二组患者人数最多。他们主要表现为疲倦和难以集中注意力，同时感到精力不足。Welte认为，治疗这些患者的挑战在于区分COVID-19引发的医疗损伤和大流行相关的社会心理变化。他总结说，只有通过减少感染人数和改变态度，COVID-19的后遗症才能得到缓解。在可预见的未来，这种病原体不太可能消失，与sars - cov -2相关的疾病将像其他传染病一样，成为我们日常生活的一部分。 For this reason, the options of prevention and therapies should be used, so as to learn to live with COVID-19.

For more information:https://www.aerzteblatt.de/int/archive/issue?heftid=6821

References:

Welte T: Post-COVID syndrome—more questions than answers. Dtsch Arztebl Int 2022; 119: 165–6. DOI: 10.3238/arztebl.m2022.0154

Förster C, Colombo MG, Wetzel AJ, Martus P, Joos S: Persisting symptoms after COVID-19—prevalence and risk factors in a population-based cohort.Dtsch Arztebl Int 2022; 119: 167–74. DOI: 10.3238/arztebl.m2022.0147

Lackermair K, Wilhelm K, William F, Grzanna N, Lehmann E, sam L, Fichtner S, Kellnar A, Estner H: COVID-19病后持续症状的流行率——一项对896名门诊治疗患者的横断面研究。Dtsch Arztebl国际2022;119: 175 - 6。DOI: 10.3238/arztebl.m2022.0125

Schulz M, Mangiapane S, Scherer M, Karagiannidis C, Czihal T: Post-acute sequelae of SARS-CoV-2 infection—characterization of community-treated patients in a case–control study based on nationwide claims data. Dtsch Arztebl Int 2022; 119: 177– 8. DOI: 10.3238/arztebl.m2022.0134

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