A recent study published in JAMA Network Open illustrates that the prevalence of new symptoms such as fatigue, shortness of breath and type 2 diabetes is higher among the hospitalized Covid-positive patients a month or longer, after being diagnosed with Covid-19.  

Researchers reviewed electronic health records of 388,024 people younger than 20 years and 1.79 million people aged 20 and older obtained from 40 healthcare systems for this study. All of them had been tested for Covid-19 between March 2020 and December 2020 and followed by visits for medical care after 31-150 days. Around 9.4% (n=168,701) of the older patients tested positive, while the percentage of positive patients in the younger age group was 7.9% (n = 26,665). The objective of the study was to compare the prevalence of new onset of some symptoms and conditions among persons who had tested positive for SARS-CoV-2 compared to the negative patients. Three settings were examined: non-hospitalized, hospitalized or hospitalized and ventilated.

Hospitalized Covid-positive patients were found to have shortness of breath more often than the hospitalised but Covid-negative patients with a prevalence ratio of 1.89 among ≥20 years and 1.72 for those <20 years. Non-hospitalized Covid-positive patients ≥20 years also reported shortness of breath compared to those who tested negative with a prevalence ratio of 1.09.

About 10.5% of hospitalized Covid-positive patients were diagnosed with shortness of breath vs 16.6% in the ventilated patients, while only 4.5% of the nonhospitalized covid positive patients reported shortness of breath.

On a similar note, the prevalence of new onset of fatigue and type 2 diabetes was higher among hospitalized patients aged 20 years or older and a positive test, with a prevalence ratio of 1.35 and 2.03, respectively compared to the Covid-negative patients. About 4.2% of non-hospitalized, 8.0% hospitalized and 19.8% ventilated patients developed fatigue.

Among the hospitalized younger patients (<20 years), the prevalence of type 2 diabetes was higher among the Covid-positive patients (prevalence ratio 2.14). Only 1.3% of the younger Covid-positive hospitalized patients developed type 2 diabetes, whereas among the older Covid-positive hospitalized patients, this increased to 7.2% and was as high as 16.7% among the Covid-positive and ventilated patients.

In the younger Covid-positive patients, 2.3% of nonhospitalized patients reported change in bowel habits compared to 6% of the hospitalized patients. Fatigue was reported by 1.7% of nonhospitalized and 3.5% of hospitalized patients, while 1.8% nonhospitalized patients had shortness of breath vs 3.9% hospitalized.

In this study, the prevalence of new onset of symptoms and conditions such as shortness of breath, fatigue, sleep disorders, change in bowel habits and diabetes after one month, was higher in hospitalized Covid patients versus the non-hospitalized patients. The probability of developing these symptoms and conditions was particularly higher in patients who had severe disease necessitating mechanical ventilation during hospitalization. Hence, physicians should be aware of the new symptoms and conditions that may develop after Covid-19 and closely monitor their patients, especially those who needed hospitalization, over long-term for post-acute sequelae of Covid-19.

This study further adds to the evidence of the beneficial effects of Covid-19 vaccines in protecting from severe Covid-19, which will also prevent the occurrence of long Covid-19. But prevention, we know, is always better than cure. And there is no time like now to emphasize the necessity of adherence to Covid-appropriate behavior like hand washing, wearing masks (double masking), avoiding crowds and poorly ventilated closed spaces, to prevent infection. In addition to the primary vaccination, all those eligible, must also take the booster “precaution” dose.

Reference

1. Hernandez-Romieu AC, et al. Prevalence of select new symptoms and conditions among persons aged younger than 20 years and 20 years or older at 31 to 150 days after testing positive or negative for SARS-CoV-2. JAMA Netw Open. 2022 Feb 1;5(2):e2147053. doi: 10.1001/jamanetworkopen.2021.47053.