Long Covid: slow improvement in symptoms after two years

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Written by Doug Hampton

The vast majority of patients (90%) suffering from long Covid see their symptoms slowly improve after two years, the others experiencing a rapid improvement or, on the contrary, a persistence of their disorders, a study reports on Friday. This study was carried out by Dr. Viet-Thi Tran, epidemiologist (Paris Cité University / AP-HP), with 2,197 patients from the “ComPare” cohort suffering from long Covid, followed regularly. His results were published in the International Journal of Infectious Diseases.

Fatigue, cough, shortness of breath, intermittent fever, loss of taste or smell, difficulty concentrating, depression… long Covid is manifested by one or more symptoms from a long list, usually within three months after infection and persistent at least two months.

It is not a single “disease” but a complex syndrome resulting from multiple often intertwined mechanisms, which explains the complex and often heterogeneous clinical picture of patients, recalls the AP-HP in a press release. According to the study, about 90% of people with long Covid still report symptoms a year after their initial infection.

The researchers were able to identify three trajectories in the patients. The overwhelming majority (91%) had a slow improvement in their symptoms over time (with an average reduction of around 25% in the number of symptoms reported within 2 years after onset).

About 4% of patients had a rapid improvement in their symptoms (with complete remission of symptoms within two years of onset). Compared to the other patients, these people were younger and had no history of functional disease (chronic fatigue, fibromyalgia, etc.). These patients more frequently presented with neck, back and lumbar pain and digestive symptoms during their acute illness.

About 5% of patients, on the other hand, had significant and persistent symptoms over time. These patients were generally older, smokers and had a history of autoimmune disease. They more frequently presented symptoms such as tachycardia, bradycardia, palpitations, arrhythmias, hot flushes, sweating and intolerance to cold and heat, during their acute illness.

These results will make it possible to better inform patients of the evolution of their long Covid and to better estimate the needs of the health system to meet the challenge of the long Covid, welcomes the AP-HP.

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