A recent study in Nature Medicine has identified a much broader spectrum of post-Covid symptoms than described earlier.¹

Researchers retrospectively analysed data of 486,149 adults with confirmed SARS-CoV-2 infection from January 2020 to April 2021 and compared it with propensity score-matched 1,944,580 adults with no evidence of SARS-CoV-2 infection. Data was obtained from a UK primary care database Their aim was to find out the association of symptoms occurring after 12 weeks of acute Covid-19 in non-hospitalized patients with long Covid.

A total of 62 symptoms occurring 12 weeks after the acute infection were identified in this study as post-Covid symptoms. Of these 20 were included in the WHO clinical case definition of long Covid. While most symptoms were in concurrence with previous studies such as anosmia (adjusted hazard ratio 6.49), sneezing (aHR 2.77), shortness of breath at rest (aHR 2.20), fatigue (aHR 1.92) and pleuritic chest pain (aHR 1.86), some new symptoms were also noted such as hair loss (aHR 3.99), sneezing (aHR 2.77), ejaculation difficulty (aHR 2.63) and reduced libido (aHR 2.36). After 12 weeks, 5.4% patients reported at least one symptom that was mentioned in the WHO definition of long Covid compared to 4.3% among those who did not have Covid.

The study also defined risk factors that increased the likelihood of developing long Covid symptoms in patients with confirmed Covid-19. These included female sex (aHR 1.52), smoking, high BMI, poor socioeconomic status, ethnic minority groups, various comorbid conditions. The risk was also high “along a gradient of decreasing age”. The symptoms could largely be clubbed into three main phenotypes: General symptoms 80% (such as pain, fatigue and rash), respiratory symptoms ~6% (such as cough, shortness of breath and phlegm). The third group (14.2%) included mental health symptoms (such as anxiety, depression, insomnia and brain fog). These findings could be useful to the clinicians in evaluating patients with long Covid.

Reference

1. Subramanian A, et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med. 2022 Jul 25. doi: 10.1038/s41591-022-01909-w.