Atlanta, GA—Many patients who recover from COVID-19 suffer persistent symptoms. While exactly how “long COVID” manifests is not well understood, it is clear that the lingering health effects are an emerging public health concern.

That’s why the CDC sought to learn more about how patients with verified SARS-CoV-2 infection compared with the general population of adults with negative test results in terms of continuing symptoms.

The CDC commissioned a survey to a nationwide sample of U.S. adults to compare the prevalence of long-term symptoms—defined as those lasting more than 4 weeks since onset—among those who self-reported ever receiving a positive SARS-CoV-2 test result with the prevalence of similar symptoms among persons who reported always receiving a negative test result. The survey, which involved more than 6,000 responses, was administered by Porter Novelli Public Services, using a nonprobability-based Internet panel.

Results indicate that about two-thirds of respondents who had received a positive test result reporting experiencing long-term symptoms often associated with SARS-CoV-2 infection.

An article in the CDC’s Morbidity & Mortality Weekly Report notes that, compared with respondents who received a negative test result, those who received a positive test result reported a significantly higher prevalence of:
• Any long-term symptom (65.9% versus 42.9%)
• Fatigue (22.5% versus 12.0%)
• Change in sense of smell or taste (17.3% versus 1.7%)
• Shortness of breath (15.5% versus 5.2%)
• Cough (14.5% versus 4.9%)
• Headache (13.8% versus 9.9%)
• Persistence (>4 weeks) of at least one initially occurring symptom (76.2% versus 69.6%).

In addition, a larger proportion of those who received a positive test result said they believed receiving a COVID-19 vaccine had made their long-term symptoms better (28.7% versus 15.7%).

“Efforts to address post-COVID conditions should include helping health care professionals recognize the most common post-COVID conditions and optimize care for patients with persisting symptoms, including messaging on potential benefits of COVID-19 vaccination,” the CDC authors point out.

The article adds that the findings “can aid efforts to address post-COVID conditions and messaging on potential benefits of vaccination.”

Background information in the articles recounts how early data on post-COVID conditions primarily came from hospitalized cohorts, while more recent reports describe post-COVID conditions among nonhospitalized, asymptomatic, or mildly ill patients. The authors advise that the prevalence of the most common long-term symptoms among respondents who received a positive test result in this study was in line with earlier research.

“Estimating population-level frequency of specific long-term symptoms among the general population and patients infected with SARS-CoV-2 could help health care professionals better understand the types and prevalences of symptoms their patients might experience and could help guide health systems in preparing care management strategies for patients with post-COVID conditions,” the CDC study notes.

Among respondents who initially reported symptoms during the month of their first positive test results, more than 75% reported persistence of any symptoms longer than 4 weeks. About half of them reported hair loss, cognitive dysfunction, shortness of breath, and postexertional malaise.

The survey asked about change in mood; change in smell or taste; chest pain or pressure; cough; diarrhea; difficulty thinking clearly, concentrating, forgetfulness, memory loss, or “brain fog”; fatigue, tired, or weakness; fever or chills; hair loss; headache; joint or muscle pain; nausea or vomiting; heart palpitations; post-exertional malaise; problems sleeping; shortness of breath or breathlessness; sore throat; stomach pain; or other symptoms.

In terms of the effect of vaccination on the symptoms, the report says preliminary research suggests vaccination is not associated with worsening of post-COVID conditions. “However, because no data were collected on the trajectory of long-term symptoms in persons who had not been vaccinated, whether any of the observed changes in symptoms are attributable to vaccination is uncertain,” the authors add. “More data are needed to fully understand the effects of COVID-19 vaccines on persons with post-COVID conditions.”

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