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Opinion A new study offers important clues about the impact of long covid

A health-care worker prepares a dose of the Novavax coronavirus vaccine at a pharmacy in Schwenksville, Penn., on Aug. 1. (Hannah Beier/Bloomberg)

The term “long covid” came from early patients who called themselves “long-haulers” when their pandemic maladies lingered for months. It is now increasingly apparent that long covid presents a potential tidal wave of suffering — afflictions stemming from covid-19 that refuse to go away. The scope of the problem is still unknown. But a new study from the Netherlands offers important clues.

In a paper published in the Lancet, Aranka Ballering and colleagues at the Lifelines Corona Research Initiative report on an effort to discover the nature and prevalence of post-covid conditions based on a large population sample. The report corrects for those who had certain symptoms before the virus infection, and also for disease dynamics in the general population. That helped them drill down on actual damage caused by the pandemic. They found that post-covid symptoms lingered in about 1 in 8 people. If true, such a proportion could mean 70 million or more sufferers of long covid worldwide based on the total of over 588 million infected to date, and probably far more. Some studies have given even higher prevalence. The Centers for Disease Control and Prevention found in a recent large study that 1 in 5 adults from 18 to 64 years old who had covid, and 1 in 4 aged 65 years and over, had at least one persisting health condition related to their covid infection. Yet another survey put the prevalence at 43 percent.

The Netherlands study was based on digital questionnaires sent to patients between March 31, 2020, and Aug. 2, 2021 — mostly before the delta and omicron waves — and recorded long-covid symptoms from three to five months after the initial infection. The main symptoms bothering people were chest pain, difficulties with breathing, lump in throat, pain when breathing, painful muscles, heavy arms or legs, loss of taste and smell, alternating feelings of hot and cold, tingling extremities, and general tiredness. The study found some symptoms that were “not significantly increased” in severity at 90 to 150 days after infection, suggesting they might not be associated with long covid: headache, itchy eyes, dizzyness, back pain and nausea.

Other studies have identified a broader constellation of troubles among long-haulers affecting nearly every organ system. What the new study did not include, but remains a serious complaint among long-covid patients, is cognitive difficulty — so-called brain fog in the aftermath of covid.

A recent research plan published by the Biden administration makes the point that long covid is real, but the impact is not yet fully grasped. Disease and disability could force many people to work less, or differently, affecting the economy and workplace; the health-care burdens could be enormous; long covid could exacerbate racial, ethnic and economic disparities. The Biden plan notes, “Pandemics such as influenza and polio resulted in long-term consequences that persisted for decades.” So will this pandemic. The challenge is going to be how to cope with it for years to come.

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