Persistent Symptoms After COVID-19 Recovery Can Affect Function for a Year
Patients who recovered from COVID-19 last fall or winter might still be having bothersome symptoms from so-called long COVID, according to a new study. Cognition, ability to work, participate in physical activities or even interact with others can all be symptoms of post-acute COVID syndrome (PACS). Here is more information.
NEW YORK – Long COVID might persist much longer than previously expected.
A new study suggests that patients experiencing post-acute COVID syndrome (PACS), commonly known as Long COVID, can have symptoms for at least 12 months after their initial COVID-19 infection. Mount Sinai-led researchers said a range of abilities can be affected and that patients might have problems with cognition, the ability to work, participation in physical activity, interaction with other and overall quality of life.
The authors advise that their study, published in the American Journal of Physical and Rehabilitation Medicine, is among the first to assess actual impairment and impact of PACS on patients, as well as elucidate factors that can exacerbate their symptoms.
“With millions of Americans at risk of developing PACS by the end of the pandemic, a second, longer-term public health emergency has emerged. It is imperative to understand the burden of this novel condition and develop targeted interventions to help patients participate in daily activities, as well as policies that will assist them with their disability and employment status,” said senior author David Putrino, PhD, Director of Rehabilitation Innovation for the Mount Sinai Health System. “This study is a concerning reminder of how severely debilitating PACS symptoms are, the toll they take on health and wellness, and the fact that, without active treatment, these symptoms appear to persist indefinitely.”
The cross-sectional observational study design involved patients attending Mount Sinai's PACS Clinic. Participants were given surveys requesting patient-reported outcomes. The 156 patients who completed the survey, all of them pre-vaccination, had a median (range) time of 351 (82 to 457) days post COVID-19 infection.
Results indicate that the most common persistent symptoms reported were:
- fatigue (n = 128, 82%),
- brain fog (n = 105, 67%) and
- headache (n = 94, 60%).
Patients reported that their most common triggers leading to symptom exacerbation were:
- physical exertion (n = 134, 86%),
- stress (n = 107, 69%) and
- dehydration (n = 77, 49%).
Weather changes were reported as a factor by more than a third of respondents.
“Increased levels of fatigue (Fatigue Severity Scale) and dyspnea (Medical Research Council) were reported, alongside reductions in levels of regularly completed physical activity,” the authors write. ‘Ninety-eight (63%) patients scored for at least mild cognitive impairment (Neuro-Qol), and the domain of the EQ-5D-5 L most impacted was Self-care, Anxiety/Depression and Usual Activities.”
“Many of the symptoms reported in this study have been measured, but for many, this is the first time they have been objectively documented using well-validated patient-reported outcomes, and linked to changes in activities of daily living and quality of life,” Putrino added. “The long duration of these symptoms remind us that this is a problem that is not going away and that we need to aggressively pursue policies that will better support and protect these patients in the long-term. Future research should focus on more detailed monitoring of PACS symptoms—better understanding how and why they are happening will be crucial in developing targeted treatments.”