How to understand if you have Long Covid? Researchers have tried to answer this question with a scientific project that has reviewed all the possible ‘red lights’ to keep under control and has identified 12 distinctive symptoms for this condition, also known as PASC (post-acute sequelae of infection from Sars-CoV-2). A problem of significant dimensions, the experts point out, if we consider that over 650 million people worldwide have been infected with Sars-CoV-2.
Long Covid is characterized by a wide range of symptoms that occur or persist for more than 30 days after infection. To better understand the prevalence and severity of these symptoms, the National Institutes of Health (NIH) launched ‘Researching Covid to Enhance Recovery’, with researchers from Mass General Brigham leading the statistical analysis. The results of the ‘Recover’ study, one of the largest Nih studies ever funded, therefore clarify the ‘list’ of symptoms that most define Long Covid. The findings, published in ‘Jama’, include a new scoring system to help doctors and researchers better define the cases they are following and study targeted treatments for patients.
“Now that we can identify people with Long Covid, we can start doing more in-depth studies to understand the biological mechanisms at play,” said corresponding author Andrea Foulkes (Harvard Medical School and Massachusetts General Hospital). “One of the great results was showing heterogeneity: Long Covid is not just a syndrome; it is a syndrome of syndromes”. A wide range of symptoms in organ systems have been documented so far, affecting patients after Covid. Recover-Adult, a prospective study that began enrolling participants in October 2021, sought to harmonize data acquisition and build a definition for Long Covid. The researchers analyzed the results of a symptom survey distributed to 85 hospitals, health centers and organizations in 33 states, Washington DC and Puerto Rico.
The survey included 37 different symptoms and corresponding measures of severity. In the end, among the 12 that emerged as hallmarks of Long Covid, the following included, for example: post-exertional malaise (debilitating fatigue exacerbated by physical or mental activity), loss or change of smell or taste, dizziness, brain fog , gastrointestinal symptoms, palpitations and chronic cough. Some of these symptoms are experienced by most people with Long Covid. Others, such as loss or change of smell and taste, are less common but still important in identifying people with the syndrome.
An algorithm developed by the researchers evaluates these 12 symptoms to generate an overall ‘Pasc score’, but the authors point out that an individual with symptoms excluded in the scoring system can still suffer from Long Covid and deserves high quality care in any case.
Finally, the authors report, the results of the study suggest that reinfections, infection with a pre-Omicron variant, and lack of vaccination are associated with a higher frequency and severity of Long Covid, but at the same time it is pointed out that continuous research is needed, also to consolidate these suggestions. Future studies by the Recover Consortium will analyze risk factors for Long Covid, including social determinants of health. The researchers are also examining how long Long Covid can manifest itself in children, adolescents and women who were pregnant during Sars-CoV-2 infection.
