More than half of COVID survivors struggle to shake off direct, indirect symptoms

A systematic review of 57 studies representing more than a quarter-million COVID cases has turned up some distressing statistics on survivors—not least those considered “long-haulers.”  

At check-in intervals of up to six months or more after initial recovery, 54% of these patients still had one or more symptoms of varying types and degrees.

Chest problems observable on imaging appeared at a 62% clip. These were followed by general functional impairments (44%), fatigue or muscle weakness (38%), anxiety disorders (30%) and difficulty concentrating (24%).

Other symptoms presenting over a protracted period included cardiac, dermatologic, digestive and otolaryngological ailments.

The review was conducted at Penn State Health and published Oct. 13 in JAMA Network Open.

Senior author Vernon Chinchilli, PhD, and colleagues point out that the viral mechanisms causing postacute and chronic expressions of COVID infection remain murky.

Still, they suggest, it’s useful to categorize the long-term symptoms by those directly connected to the viral infection and those evidently tied to the indirect effects on indicators of mental health. These might include PTSD, social isolation and economic factors such as the loss of work time.

Chinchilli and co-authors further note that multiple sets of recommendations and best practices are in circulation to guide COVID prevention and initial care.

However, they underscore, “no clear guidelines are currently available for postinfectious care or recovery, and there is a notable dearth of information on and strategies about how to assess and manage patients following their acute COVID-19 episode.”

The review team’s primary conclusion:

These findings suggest that COVID-19 postacute sequelae (PASC) is a multisystem disease, with high prevalence in both short-term and long-term periods. These long-term PASC effects occurred on a scale sufficient to overwhelm existing healthcare capacity, particularly in resource-constrained settings. Moving forward, clinicians may consider having a low threshold for PASC and must work toward a holistic clinical framework to deal with direct and indirect effects of SARS-CoV-2 sequalae.”

The study is available in full for free.

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