A whopping 30% of COVID-19 patients end up developing post acute sequelae of COVID-19, known as long COVID-19.
That’s according to a recent study from the University of California Los Angeles (UCLA) published in the Journal of General Internal Medicine. The findings are striking and underscore the huge population of patients who continue to be impacted by COVID-19 long after they are infected.
Researchers defined long COVID by determining if patients reported persistent symptoms on questionnaires 60 or 90 days after infection or hospitalization. The study is critical for understanding the long-term impacts of COVID-19 infections and the risk factors for long COVID. The study included 1,038 people who were enrolled in the UCLA COVID ambulatory program between April 2020 and February 2021. Of this cohort, 309 developed long COVID.
Among the long COVID patients who were hospitalized, 31% reported fatigue and 15% reported shortness of breath as long COVID symptoms. Fatigue was also the most reported symptom among outpatients, followed by shortness of breath and loss of taste or smell. Other rarer symptoms included persistent fever and rash.
Researchers analyzed a large, diverse cohort within a single health system, which helped control for some factors such as healthcare access and quality of care.
“Studying outcomes in a single health system can minimize variation in quality of medical care,” Sun Yoo, MD, health sciences assistant clinical professor at David Geffen School of Medicine at UCLA and medical director of the Extensivist Program, said in a statement.
The study had some potential weaknesses, in part because patients were asked to rate their symptoms––a subjective task that underscores the challenges measuring and analyzing long COVID. In addition, researchers limited the number of symptoms that were evaluated and had limited information about patients’ pre–existing health conditions.
However, there were several characteristics associated with long COVID noted in the study. Patients were more likely to report having symptoms of long COVID if they had a history of hospitalization, diabetes and higher body mass index. By comparison, those covered by Medicaid, rather than commercial health insurance, as well as those who had undergone an organ transplant were less likely to develop long COVID.
In addition, researchers were surprised that ethnicity, older age and socioeconomic status were not associated with long COVID, even though those characteristics have been linked with severe illness and greater risk of death from COVID-19. The study also contracted existing literature that suggests women were more likely than men to develop long COVID. UCLA researchers found no such trend in its study.
“Our study also raises questions such as: Why were patients with commercial insurance twice as likely to develop long COVID than patients insured through Medicaid?” Yoo asked. “Because persistent symptoms can be subjective in nature, we need better tools to accurately diagnose long COVID and to differentiate it from exacerbations of other emerging or chronic conditions. Finally, we need to ensure equitable access to outpatient long COVID care.”
Researchers are interested in the implications of some of the findings, including why Medicaid patients fared better.
“Understanding the effects of long COVID will allow for more effective education among patients and providers, and allow for appropriate healthcare resource utilization in the evaluation and treatment of PASC,” Yoo et al wrote.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."