Oct. 12, 2022 – A significant number of people who get COVID-19 continue to have some type of symptoms for months or only feel somewhat better after recovery, according to a new large study published in Nature Communications.

Between 6 and18 months after infection, 1 in 20 people hadn’t fully recovered, and 2 in 5 had only improved somewhat.

“There are lots of different impacts going beyond health – to quality of life, employment, schooling and the ability to look after yourself,” Jill Pell, PhD, one of the study authors and a professor of public health at the University of Glasgow, told The Washington Post.

Pell and colleagues are doing a study of long COVID in Scotland, called the Long-CISS (Covid in Scotland Study). In this analysis, she and colleagues looked at 33,281 people with laboratory-confirmed infections and 62,957 never-infected people who answered questionnaires at 6, 12, and 18 months during the pandemic, as well as hospitalization and death records.

Among 31,486 people with symptomatic infections, 1,856 (or 6%) hadn’t recovered at all in their most recent follow-up survey. Another 13,350 people (or 42%) had only recovered partially.

People who hadn’t recovered were more likely to be hospitalized due to COVID-19 and have other mental and physical conditions such as depression and respiratory disease. The risk of long COVID was also higher among women, older adults, and those who live in economically disadvantaged areas.

“It has always been the case that those who are sicker are more likely to have long-term sequelae,” David Putrino, PhD, director of rehabilitation innovation for the Mount Sinai Health System in New York, told the newspaper.

“What is frightening is that the mild cases by far outnumber the severe, so even a small percentage of mild cases going on to develop long-term sequelae is a massive public health concern,” he said.

A previous symptomatic infection was also linked to poorer quality of life, trouble with daily activities, and 24 persistent symptoms. Those with symptomatic infections were 3.4 times as likely to have breathlessness, 2.9 times as likely to have confusion or brain fog, 2.5 times as likely to have heart palpitations, and 2 times as likely to have chest pain.

At the same time, people with asymptomatic infections were less likely to have long-term issues, and asymptomatic infection wasn’t linked to any adverse outcomes. Vaccination also appeared to offer some protection from long COVID and was linked to a lower risk of seven symptoms.

So far, many studies focused on long COVID have been challenged by the wide-ranging nature of the long-term condition, the Post reported. Since the Covid in Scotland Study included a control group, researchers were able to pinpoint which symptoms appeared to be linked to COVID-19 in particular.

“Those who had COVID were significantly more likely to get 24 of the 26 symptoms studied, compared to the never-infected general population,” Pell said.

Pell and colleagues have planned more studies, including a focus on the changes in symptoms over time and which risk factors are linked to those changes. 

Public health researchers worldwide are also interested in data about vaccination, previous infection, and ongoing symptoms in Scotland and Britain due to the nature of the nationalized health system, which can reflect trends across the full population.

“It’s one more well-conducted, population-level study showing that we should be extremely concerned about the current numbers of acute infections,” Putrino said. “We are in trouble.”

Show Sources


Nature Communications: “Outcomes among confirmed cases and a matched comparison group in the Long-COVID in Scotland study.”

The Washington Post: “Large study provides powerful evidence of long covid’s lasting impact.”

Covid in Scotland Study: “A study into the long term effects of COVID-19 on the people of Scotland.”

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