Increased risk of developing new conditions in patients with Covid-19

According to American researchers, a higher percentage of patients with Covid-19 than others develop one or more new conditions requiring clinical care during the post-acute phase of their disease.

The results of their observational study, published in the British medical journal, shed more light on the so-called ‘long Covid’ that affects some patients after recovery from an initial coronavirus infection.

“Further monitoring is needed to determine risk resolution over time”

Authors of the study

Previous evidence has shown that people of all ages and backgrounds have experienced a range of persistent and chronic symptoms beyond the expected recovery window of two to three weeks.

The new study found that 14% of adults aged 65 and under who were infected with Covid-19 had at least one new condition requiring clinical care after the acute phase of their initial illness. The study authors said it was 5% higher than the new conditions seen in adults without coronavirus infection in 2020.

The conditions involved a range of organs and systems, including the heart, kidneys, lungs and liver, as well as mental health complications, the researchers noted.

They said the results indicated an excessive risk of developing a new clinical condition after the acute phase of Covid-19, including specific types of illness less commonly seen in other viral illnesses.

The authors said that previous small studies suggested that some Covid-19 survivors had developed short- and long-term clinical conditions, but few had examined the excessive risk of new conditions due to coronavirus infection beyond the initial recovery period of about three weeks.

To fill this gap, researchers at OptumLabs of the UnitedHealth group in Minneapolis set out to assess the excessive risk of developing new conditions after the acute phase of coronavirus infection.

They examined the health records of 266,586 adults, aged 18 to 65, diagnosed with Covid-19 from January 1 to October 31, 2020 and looked at whether they had been diagnosed with at least one of the 50 conditions up to at six months after the initial infection.

Individuals were matched to comparison groups without Covid-19 infection from 2020, 2019, and to a group diagnosed with other lower respiratory viral infections.

The results showed that 14% of adults infected with Covid-19 had at least one new condition requiring medical attention after the acute phase of the illness. This was 5% higher than the 2020 comparison group and 1.65% higher than the other group of lower respiratory viral diseases.

The risk of specific conditions within four months of the acute phase of infection – including chronic respiratory failure, heart rhythm problems, amnesia, diabetes, anxiety and fatigue – was higher than in all comparison groups.

“Health professionals should be alert to the possibility of a long Covid in anyone with confirmed or suspected Covid-19”

Elaine maxwell

While the absolute risk was low – 0.02 to 2.26 more per 100 people developing specific types of conditions compared to the 2020 comparison group – it persisted for up to six months after infection.

The risk increased with age, pre-existing conditions, and admission for Covid-19. But young adults under the age of 50, those without any pre-existing conditions and those who were not admitted were also at risk.

The researchers warned that, as the number of individuals infected with the coronavirus continues to increase, “the number of survivors with potential [conditions] after covid will continue to grow ”.

In one linked editorialDr Elaine Maxwell, of the National Institute for Health Research, said it was too early to predict how long the conditions would persist after Covid-19, but that their symptoms were clearly a “major personal burden for many people”.

She pointed out that the estimated incidence of 14% of new diagnoses up to six months after infection was “surprisingly similar” to the 13.7% incidence of self-reported symptoms lasting more than 12 weeks found by the Office. British National Statistics.

Elaine maxwell

Dr Maxwell, who is responsible for content at the NIHR Center for Engagement and Dissemination and nursing, is the author of a see again published in October which found that the reported symptoms were so broad that the long term Covid could actually be used as a ‘catch-all’ for up to four different syndromes.

Commenting on the new study, she pointed out that risk factors differed between new diagnoses, which hampered attempts to predict who would develop particular symptoms and when.

She also noted that the absolute number of people reporting long symptoms of Covid would be higher in the community, due to a difference of at least 10 times between the number of hospital admissions and those who stayed. at home.

“Primary care clinicians should expect patients with mild initial infections to report symptoms of Covid or long post-covid as often as those who were critically ill,” said Dr Maxwell.

She added: “Healthcare professionals should be alert to the possibility of a long Covid in anyone with confirmed or suspected Covid-19. How to deal with these longer-term consequences is now an urgent research priority. “

About Geraldine Higgins

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