Long COVID has diverse symptoms, affects multiple organs: Study

After recovery from COVID, patients may report more than 200 symptoms across 10 organ systems, says a recent global study.

Post-COVID, many people experience breathlessness, body ache, brain fog, and insomnia, among others. These symptoms usually last from 4-12 weeks, but in some cases, it may extend further. Such a condition is called long COVID or post-COVID. The people who do not recover from long COVID in the usual 4-12 weeks are referred to as ‘long haulers’.

The study was published in the journal EClinicalMedicine and is based on responses from 3,762 eligible participants from 56 countries. The study identified a total of 203 symptoms in 10 organ systems, of which 66 symptoms were tracked for seven months after the person tested positive. The researchers created a web-based survey designed to characterise the symptom profile and time course in patients with confirmed or suspected long COVID with prolonged symptoms.

Common symptoms of long COVID

The most common symptoms reported were fatigue, post-exertional malaise (worsening of symptoms after physical or mental exertion), and cognitive dysfunction, often called brain fog. Of the diverse range of symptoms, others included visual hallucinations, tremors, itchy skin, changes to the menstrual cycle, sexual dysfunction, heart palpitations, bladder control issues, shingles, memory loss, blurred vision, diarrhoea, and tinnitus.

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The researchers have now called for clinical guidelines on assessing long COVID to be significantly widened beyond currently advised cardiovascular and respiratory function tests. “The assessment should include neuropsychiatric, neurological, and activity intolerance symptoms,” they said.

According to the researchers, the patients will receive correct treatment only after detecting the root cause of the symptoms due to the diverse make-up of symptoms that affect multiple organ systems.

“While there has been a lot of public discussion around long COVID, there are few systematic studies investigating this population,” said Athena Akrami, a neuroscientist at University College London in the UK, and senior author of the study.

“Relatively little is known about its range of symptoms, and their progression over time, the severity, and expected clinical course (longevity), its impact on daily functioning, and expected return to baseline health,” said Akrami.

The survey was open to those aged 18 or above who had experienced symptoms consistent with COVID-19, including those with and without positive COVID-19 test. It consisted of 257 questions. In order to characterise long COVID symptoms over an extended duration, analysis of survey data was limited to respondents with illnesses lasting longer than 28 days and whose onset of symptoms occurred between December 2019 and May 2020.

Previous studies have estimated that one in seven people (30 percent) have some symptoms 12 weeks after a positive test result. In this long COVID cohort, the probability of symptoms lasting beyond 35 weeks was 91.8 per cent.

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Of the 3,762 respondents, 3,608 (96 percent) reported symptoms beyond 90 days, 2,454 (65 percent) experienced symptoms for at least 180 days and only 233 had recovered. In those who recovered in less than 90 days, the average number of symptoms peaked at week two, and for those who did not recover in the same time, the average number of symptoms peaked at month two. Respondents with symptoms over six months experienced an average of 13.8 symptoms in month seven. During their illness, participants experienced an average of 55.9 symptoms, across an average of 9.1 organ systems.

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“Memory and cognitive dysfunction, experienced by over 85 per cent of respondents, were the most pervasive and persisting neurologic symptoms, equally common across all ages, and with substantial impact on work,” Akrami added.

What’s happening in India

A survey conducted by Hyderabad-based AIG hospitals found over 40 percent of people who have recovered from COVID-19 to have long COVID symptoms. More than 2000 people, who have recovered from COVID-19, had responded to the online survey conducted by AIG hospitals, 48 per cent among whom were hospitalized, while 37.6 per cent were treated at home.

Talking to India Today about long COVID in India, Dr Ashish K Jha, Dean, Brown University School of Public Health, said, “India absolutely needs to study and understand the implications of long Covid. The data suggests the effects are certainly on the lungs, but there are also problems with the heart and brain. We should be very careful.”