A health worker tends to a patient in an intensive care unit. /
The most repeated sequelae, from which more than a million Spaniards are said to suffer, are the loss of taste and smell, muscle pain and general fatigue.
After the acute and reduced phase, thanks to health and scientific efforts, in the percentage of serious cases and above all in the number of deaths, the great problem left by the coronavirus pandemic is to determine the volume of patients with persistent covid and the gender and the intensity of its consequences. An essential step for the health system to design and articulate a response to what seems to be one of the most serious health problems for years to come.
A group of researchers from the Netherlands has made a remarkable advance in this fight to quantify the prevalence and characteristics of long-lasting covid. The work carried out by Professor Judith Rosmalen, of the University of Groningen, concludes that 12.7%, or one in eight people infected with SARS-CoV-2, maintain a permanent sequelae at least eight months after the diagnosis of infection of the disease, according to the results published in the prestigious scientific journal “The Lancet”.
This prevalence, transferred to the Spanish reality, would suggest that more than a million Spaniards suffer from some kind of persistent covid, a proportion which, if it can be confirmed, should trigger the alarms of health officials given the the enormous dimension of the problem. The data is consistent with the estimates put forward so far by some experts and preliminary work, which limited between 10% and 15% of positive patients with serious and lasting sequelae.
The work makes two other great contributions. It specifies what are the characteristic sequelae generated by covid and specifies that these are symptoms which reach their peak around three months after infection and which, therefore, stabilize and become chronic.
The most common persistent conditions are loss of taste and/or smell which is detected in 7.3% of patients, muscle pain which affects 7.3% and general fatigue or weariness which reaches 4.9%. . Other specific ailments derived from the virus are chest pain, difficulty or pain in breathing, tingling in the hands and feet, sore throat, feeling of alternating hot and cold, and feeling of heaviness in the arms and legs. .
The researchers also detect that another series of symptoms very common in the acute phase of the infection then disappears as a specific and recurrent sequelae. This list would include fever, headache, nausea and vomiting, dry cough or digestive upset, and diarrhea.
Twenty-four controls in 16 months
This is pioneering research. In addition to proposing a precise figure for the prevalence of persistent covid, it manages to determine the main sequelae of the disease as well as the relevance and frequency of each. He achieves this because he studies the positives for SARS-CoV-2 whose previous medical situation he knows, its evolution during the following 16 months and whose symptoms he compares to those suffered by uninfected citizens of the same sex. , age and territory, for which also monitors in parallel. This allows researchers to rule out prior symptoms, those that coincide between infected and uninfected, or rule out others like stress derived from lockdowns and restrictions, common to all and unrelated. with the coronavirus.
The Groningen team managed to involve in the analysis 76,422 citizens from the north of the Netherlands already involved in a large health study called ‘Lifelines’, of which 4,231 have an official positive result for SARS-CoV -2 and compare to 8,462 uninfected with equivalent characteristics. They were submitted to 24 questionnaires between March 2020 and August 2021 -weekly, fortnightly or monthly, depending on the case- in which they monitored the evolution of 23 symptoms derived from the contagion.
Limits
The researchers themselves warn against two limitations that force their results to be nuanced. They only study patients infected with the alpha variant, the main one in the first wave, so it’s unclear whether delta and omicron, responsible for most pandemic infections, have a similar impact. For the same reason, the observation of a sample of closed patients in the first weeks of the epidemic, has no results on the effect of the initial vaccination and reinforcements on the evolution of the disease. It is not known whether it decreases, as many experts have guessed, the appearance of a long-lasting covid.
In any case, Aranka Ballering, another of the main signatories of the survey, believes that the work specifies that “long-lasting covid is an urgent problem with an increasing number of victims” which obliges the health authorities to give answers. equally concrete. and urgent.
Rosmalen considers that new research is needed that pays particular attention to the study of mental health symptoms generated by the disease, such as depression and anxiety, and in others that could not be evaluated in this work, such as the so-called “brain fog”, with a loss of retention capacity, or insomnia.