“It’s one more well-conducted, population-level study showing that we should be extremely concerned about the current numbers of acute infections,” said David Putrino, director of rehabilitation innovation for the Mount Sinai Health System in New York. “We are in trouble.”
Jill Pell, a professor of public health at the University of Glasgow who led the research, emphasized that the study revealed the wide-ranging impact of long covid on people’s lives. “There are lots of different impacts going beyond health to quality of life, employment, schooling and the ability to look after yourself,” she said.
The paper, published Wednesday in Nature Communications, represents the first findings of an ongoing study into long covid — the Long-CISS (Covid in Scotland Study).
The range of reported symptoms and inability to provide a prognosis for patients have perplexed long-covid researchers, even as the breadth of the challenge has become clearer. Between 7 million and 23 million Americans — including 1 million who can no longer work — are suffering from the long-term effects of infection with the virus, according to government estimates. Those numbers are expected to rise as covid becomes an endemic disease.
Previous studies have been challenged by the nonspecific nature of long-covid symptoms, including breathlessness and fatigue, which are also common in the general population. The Covid in Scotland Study, which included a control group, was able to pinpoint which symptoms were linked to covid, Pell said.
“Those who had covid were significantly more likely to get 24 of the 26 symptoms studied compared to the never-infected general population,” she said. For example, those who were infected were 3½ times more likely to be breathless.
Putrino pointed out that between 16 and 31 percent of the control group also suffered those same symptoms — a figure that is similar to the false negative rate of a PCR test, suggesting some of the control group may have been infected. Pell agreed that it is possible that some people with negative tests could have been infected, serving to reinforce the study’s broader findings.
Long hauler symptoms range widely from person to person. In the Scottish study, the most commonly reported symptoms included breathlessness, palpitations, chest pain and “brain fog,” or reduced mental acuity.
Symptoms were worst among people who were sick enough to be hospitalized during the acute infection — a fact that does little to quell experts’ concerns.
“It has always been the case that those who are sicker are more likely to have long-term sequelae,” Putrino said. “What is frightening is that the mild cases by far outnumber the severe, so even a small percentage of mild cases going on to develop long-term sequelae is a massive public health concern.”
Putrino also warned against assuming that asymptomatic infection is not associated with persistent symptoms.
“We have seen many patients who had a confirmed asymptomatic case,” he said. “It happens. It is statistically less common than those with symptomatic infection.”
The study found that the risk of long covid was greater among women, older people and those who live in economically disadvantaged communities. People who already…
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