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Studies Cast More Light on 'Long COVID' Prevalence, Presentation

— High rates of debilitating symptoms lasting months

MedpageToday

Lingering respiratory and other symptoms were common in the 6 months following hospital discharge among patients treated for severe COVID-19 at a tertiary care center in Oklahoma.

About half of patients who responded to a survey 3 to 6 months following discharge reported continued COVID-19-related fatigue, changes in activities of daily living and/or shortness of breath.

More than 40% reported ongoing decreased sense of small and/or taste; a variety of other complaints persisted as well.

The findings are "consistent with some of the emerging data we are seeing regarding COVID long-haulers," said Eevar Rossavik, DO, of Oklahoma State University Center for Health Sciences in Tulsa, who presented the findings at the (AAAAI).

He said the survey was designed to assess long-term respiratory symptoms among patients following hospital discharge for severe COVID-19.

Although all recruited patients required hospitalization, most were not treated in intensive care units (ICUs) and did not require mechanical ventilation during their hospital stay.

The survey was small, with just 42 of the 232 formerly hospitalized patients responding.

The average age of the respondents was 59 (range 7-8), and patients or their caregivers were asked about ongoing respiratory and other symptoms caused or worsened by having COVID-19. They were also asked whether they needed additional therapy or treatments following hospital discharge.

In all, 38.1% of patients reported requiring some form of additional therapy following discharge.

Other persistent symptoms reported by respondent included:

  • Increased mucus production (38.1%)
  • Nasal congestion (28.6%)
  • Rhinorrhea (28.6%)
  • Cough (26.2%)
  • Chest tightness (23.8%)
  • Sneezing (19%)
  • Wheezing (16.7%)

Rossavik said it remains to be seen if "long-haulers" will get the resources they need to continue their recovery.

"We need to make sure we have the infrastructure needed to support these patients," he said. "Insurance issues, physical therapy, occupational therapy -- all of these things need to be considered in the context of COVID-19."

Another study presented at AAAAI is also examining post-acute consequences of COVID.

Shu Cao, MSc, of Stanford Medicine's Sean N. Parker Center for Allergy & Asthma Research, reported early data from a study of 234 people (age 4-86 years) who were enrolled a median of 34 days after COVID-19 diagnosis. After acute symptoms abated, participants agreed to return to the clinic every 1-3 months for exams.

The most commonly reported symptom at the first clinic visit was fatigue (52%), followed by headache, cough, body aches, chills and fever.

Hispanic patients (about one-quarter of the sample) reported poorer mental (P=0.004) and physical health (P=0.0003) compared to non-Hispanic participants.

Severe COVID-19 during the acute phase and having one or more underlying health conditions were both associated with poorer physical health.

In multivariable generalized linear modeling adjusted for age and gender, Hispanic ethnicity and more severe COVID-19 remained significant risk factors for poorer physical health scores.

Cao said the preliminary data "indicate that COVID-19 can lead to substantial mental health burden that may be greater among Hispanic patients."

Disclosures

Authors of both studies disclosed no relevant financial interests.

Primary Source

American Academy of Allergy Asthma & Immunology

Rossavik EB, et al "A survey of respiratory symptoms reported in patients following hospitalization with COVID-19 infection" AAAAI 2021.

Secondary Source

American Academy of Allergy Asthma & Immunology

Cao S, et al "Understanding the impact of the COVID-19 pandemic on physical and mental health" AAAAI 2021.