Analysis of 1.2 million new crown infections, JAMA releases long new crown symptom data

About 6.2% of people with Covid-19 experience at least one symptom of Covid-19

Writing |Ling Jun

Source | “Medical Community” Public Account


For the new type of coronavirus, in addition to being infected, there is another issue that deserves attention – long-term symptoms of the new coronavirus.

In the more than two years since the epidemic, the statistics on the incidence of long-term new crowns vary greatly. A data from the US Centers for Disease Control and Prevention put it at about 19%, and a study in the Journal of Infectious Diseases in April this year put it at nearly 50%. According to a previous study by Chinese experts on patients discharged from the domestic epidemic, 55% of the 1,190 patients who recovered from the new crown still had symptoms of the new crown two years later.

Yesterday (10th), the latest study of JAMA “Journal of the American Medical Association” summarized 44 published papers, 10 national collaborative studies, 2 electronic case databases, a total of 22 Health data on about 1.2 million people with Covid-19 in the country found that about 6.2% of people with Covid-19 experienced at least one prolonged Covid-19 symptom after three months, but symptoms improved over time.

The data of this study comes from 2020 and 2021. The symptoms of long-term new crown are classified into three categories, and the diagnosis standard is based on the World Health Organization – that is, after 3 months of infection with the new crown, people who have recovered but have recovered Symptoms that persist and cannot be explained by the diagnosis of other diseases.

Analysis found that three months after infection, 3.7% of COVID-19 survivors had persistent breathing problems, 3.2% experienced physical pain, mood swings or persistent fatigue, and 2.2% had cognitive problems . A year later, the proportion with at least one long-term Covid-19 symptom dropped to 0.9%.

At the same time, the incidence of long-term new crown is also related to the severity of infection. For infected people who are not hospitalized, hospitalized, and admitted to ICU for treatment, the incidence of long-term new crown is 5.7%, 27.5% and 43.1%, respectively. %.

In terms of duration, non-hospitalized patients experience prolonged COVID-19 for about 4 months, hospitalized patients for 9 months, and 85% of people experience remission after one year.

It is worth mentioning that the incidence of long-term new crown also shows gender and age differences. About 63.2% of long-term new crown patients are women, and the risk of people under the age of 20 is also lower.

University of California, San Francisco, infectious disease physician Michael Peluso told an academic forum last week that women tend to be more affected than men. At the same time, people with underlying diseases, obesity, and low socioeconomic status are also more likely to develop new crowns.

Keep the long definition of Covid-19 broad,

Although it looks too “horrifying”

At present, the specific mechanism of the occurrence of the new crown is not clear.

Due to the very broad classification of COVID-19 symptoms – as many as hundreds, including Ebola virus, respiratory syncytial virus, influenza and other infections, similar symptoms may appear. One study showed that 1-6 months after infection (leading to hospitalization), the new coronavirus poses a 1.27 times higher risk of developing at least one new coronavirus or new disease than the seasonal flu virus.

Healthy people have similar problems.

According to a study in Nature Medicine on July 25, at 3 months, 5.4% of people with COVID-19 who were not hospitalized and healthy people reported long-term symptoms of COVID-19, respectively. 4.3%. A Danish study pointed out that among 12-14 year olds who recovered from the new crown, the proportion of at least one “long new crown” symptom reached 46%, but in the uninfected group, 41.3% of the children reported symptoms.

This may be due to the ambiguity in the diagnosis of the new crown. Currently, there are no uniform biomarkers or imaging tests available for diagnosing COVID-19. Some minor symptoms of fatigue, insomnia, anxiety, etc., are mostly defined by the patient’s chief complaint, and the interference of psychological or other factors cannot be completely ruled out.

Occurrence Hazard Ratios for Some Long-term New Coronary or New-Onset Diseases

Meanwhile, a study of 100,000 people published in The Lancet in June showed that the odds of developing Covid-19 after infection with Omicron have dropped by about 50% compared to the delta variant. 20%-50%.

Promotion of vaccination has also reduced the incidence of new crowns, but the effect is not clear. In a study published in The Lancet Infectious Diseases in January, two-dose vaccination reduced the incidence of long-term new crowns by about 50%, while a study in Nature Medicine in May showed that the risk was reduced by only about 15%. %.

Nevertheless, one suggestion from the academic community is to maintain the “broadness” of the long definition of Covid-19 until it is thoroughly researched – even if this makes the relevant data look more “horrifying” , but avoids the exclusion of large numbers of patients from rehabilitation programs.

“Coronavirus infection is relatively more likely to cause chronic health problemslow, but a high number of cases also creates a high disease burden. ” said Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine.

Thousands of battered COVID-19 survivors have gone to private medical facilities to seek “bloodwashing,” according to a July survey by The BMJ “treat. Through apheresis, the blood is filtered out of circulating factors related to inflammation and blood clotting – which are thought to be related to the “long new crown”. Other unproven private treatment attempts include dietary supplements, vitamins, infusions, ozone therapy, and more.

“Who can blame these patients for pursuing experimental and unproven treatments?” Australia’s “Conversation” website commented that in terms of high-quality trials of long-term new crown treatments, the world has is blank. Steven Deeks, a researcher at the University of California, San Francisco, called for more research on the “long new crown” and accelerated development of treatments.

Source: Medicine

Proofreading: Zang Hengjia

Editor in charge: Tian Dongliang

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