Risk factors for long COVID: what we know

After recovering from COVID-19, many experience long-term symptoms including brain fog, fatigue and rashes. This syndrome is known as long COVID, and researchers are in the early stages of understanding its risk factors.

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What do we know so far about the risk factors for long COVID? Louise Delmontte/Bloomberg via Getty Images.

According to Centers for Disease Control and Prevention (CDC)long COVID is a condition in which health problems related to COVID-19 last for 4 weeks or more after contracting the virus that causes the disease.

Even those who did not have symptoms of COVID-19 immediately after contracting SARS-CoV-2 can develop long COVID. Symptoms can last for several weeks or months.

Research suggests that at least 54% of those who develop COVID-19 live long with COVID. According to a Meta-analysis 2021The most common findings and symptoms in people with long-term COVID include:

  • chest imaging abnormalities for 62.2% of people
  • general functional disorders for 44%
  • muscle fatigue or weakness for 37.5%
  • general pain for 32.4%
  • generalized anxiety disorder for 29.6%
  • sleep disorders for 27%
  • difficulty concentrating for 23.8%

Other symptoms include:

Research is emerging on risk factors for long COVID. To help analyze these studies, DTM summarized some of the key findings to date. We also spoke with three experts about the best ways to mitigate risk factors for long COVID.

A study who followed 309 participants for 2-3 months after contracting SARS-CoV-2 identified four factors that increase a person’s risk for long COVID:

However, the study authors noted that their research may not be conclusive because they could not confirm causation, and their sample size makes it difficult to pinpoint specific predictors.

Nevertheless, other studies support their conclusions. A study found that SARS-CoV-2 can reactivate EBV and, in turn, lead to long-lasting COVID symptoms. About 95% of the world’s population carries this virus, although EBV remains largely inactive and asymptomatic.

Another study found that older age, being female, and having pre-existing health conditions were also linked to long COVID.

“Clinical risk factors are largely related to disease severity, length of hospitalization, age at infection, and pre-existing comorbidities, such as lung disease, asthma, diabetes, etc.”, said Professor Elizabeta Mukaetova-Ladinska, professor of old age psychiatry at the University of Leicester in the United Kingdom, told Medical News Today.

“Thus, the severity of SARS-CoV-2 infection can nearly quadruple the risk of long COVID, pre-existing lung disease and asthma increase the likelihood [by] six- [and] nearly 10 times, respectively, while age increases the risk by 67%,” she added.

“Furthermore, female gender and age under 50 are now also recognized as risk factors for a long time COVID. The latter is important, since [there] seems to be some overlap of symptoms of long COVID with those of perimenopause and menopause,” she explained.

Professor Mukaetova-Ladinska further explained that lower levels of antibodies immunoglobulin (Ig) IgM and IgG3when combined with clinical risk factors, may also increase a person’s risk of developing long-lasting COVID.

She further said that research suggests a link between gut microbiome alterations and long COVID: “Namely, COVID-19 patients with healthy gut bacteria and a microbiome similar to [that of a healthy person] seem less likely to develop long COVID, whereas COVID patients who develop long COVID have a less diverse and abundant microbiome.

Asked about likely risk factors for long COVID, Dr. Donald J. Alcendor, adjunct associate professor of pathology, microbiology, and immunology at Vanderbilt University School of Medicine, said DTM this “[t]he most important risk factor for long COVID is not being vaccinated, getting a primary COVID-19 infection, and having [one or more] underlying health [conditions].”

“Studies show that getting vaccinated will significantly reduce your risk of developing long COVID. Being vaccinated with a single dose of the COVID-19 vaccine even after being diagnosed has also been shown to reduce your risk of developing long COVID.

– Dr. Donald J. Alcendor

“Finally, people who received at least one dose of any of the three COVID-19 vaccines – Pfizer-BioNTech, Moderna, and Johnson & Johnson – before diagnosis were 7-10 times less likely to have two long COVID symptoms. or more compared to unvaccinated people,” he added.

Although the study cited by Dr. Alcendor has not yet been peer-reviewed, other research published in peer-reviewed journals supports these claims.

For example, a study published in The Lancet: infectious diseases in January 2022 found that the two-dose vaccination roughly halved the chances of showing symptoms of COVID-19 for 28 days or more after the initial illness.

Dr Alcendor also warned of the risk to children: “We must remember that children, although [this is] rare, can develop long COVID and people who have breakthrough [or] post-immune infections or asymptomatic COVID infections can also develop long COVIDs. Some people who have developed long COVID have recovered after being vaccinated.

A press release from the UK Health Security Agency supports his remarks. The statement highlights a recent review of 15 studies, suggesting that those who have been vaccinated are less likely to experience long COVID than unvaccinated people.

Asked about ways people can lessen their chances of developing long COVID, Dr. Janis Orlowski, director of health care at the Association of American Medical Colleges, said DTM“Take good care of yourself and, if you are [someone who has diabetes], trying to maintain normal blood sugar levels, exercise and general good health always helps. We will continue to study and learn more in the future.

To the same question, Dr. Alcendor once again emphasized the importance of getting vaccinated: “The most important mitigation strategy against the long COVID is to get vaccinated and boost. If the vaccine is contraindicated for [a person]then they should practice the CDC’s mitigation protocols of social distancing, masking, and hand washing.

“This is especially important indoors or in crowded, poorly ventilated spaces. Other members of their household should be vaccinated if they are eligible or follow the mitigation protocol if they are not eligible or if they are not vaccinated,” he added.

Professor Mukaetova-Ladinska said that as we are still in the early stages of understanding long COVID, potential treatments and mitigation strategies are largely based on those for chronic illnesses or other post-viral syndromes.

As long as COVID presents as a variety of symptoms, she stressed the importance of multidisciplinary action, including occupational therapy, physical therapy, mental health support and medical intervention.

She also noted new ways currently being explored to alleviate and manage long-lasting COVID symptoms:

“A new therapeutic intervention that alters the gut microbiome may help alleviate and even normalize long-running COVID symptoms. Based on previous studiesthis can be achieved via high dietary fiber intake, low choline plant foods, fruits and vegetables, foods with prebiotics, anti-inflammatory omega-3s, regular gut motility, intermittent fasting, etc. .

Finally, Professor Mukaetova-Ladinska warned against taking medication for a long period of COVID without consulting a medical professional.

“Many long-term COVID sufferers have sought information and sought help outside […] medical circles. This is largely due to the lack of information and understanding of the long COVID and, in some cases, limited access to overwhelmed health services,” she said.

“It’s no surprise that over-the-counter drugs and social media platforms have been widely used, with people subject to expensive and sometimes harmful drugs and drug interactions, [alongside] conflicting information. There is a compelling need to understand current self-management practices regarding long COVID, [including] their advantages and disadvantages, and [to] subject them to evidence-based rigor,” she concluded.

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