How long does Long-Covid last? This is the question asked by many people who are still suffering from symptoms such as tiredness, shortness of breath and brain fog after their corona infection. A recent study gives hope. All important questions at a glance.
Sometimes it’s weeks, sometimes months – complaints such as fatigue, mental impairment and pain continue. The corona test has long been negative. Long-Covid or Post-Covid is likely to affect hundreds of thousands of people in Germany. Exact numbers are difficult to give. The clinical picture is too multifaceted, the definition is unclear and it is often not recognized.
And yet, a new study published in the British Medical Journal (“BMJ”) provides good news: Most long-Covid symptoms disappear within a year – at least for those who have a mild course of Covid-19 had.
Researchers followed nearly 300,000 children and adults suffering from mild Covid-19 (meaning they were not hospitalized). Some were vaccinated when they became infected, others were not. For comparison, the researchers followed about 300,000 people with similar demographics who did not test positive for Covid-19. They examined the period between March 2020 and October 2021, the omicron variant was not yet dominant here.
Doctors distinguish between “Long-Covid” and “Post-Covid”.
In general usage, “Long-Covid” has mainly spread, which is why this text remains with this designation. The term post-Covid syndrome (PCS) defined by the World Health Organization (WHO) has become established in the medical literature, including the S1 guideline of the Association of Scientific Medical Societies (AWMF). A detailed literature review has been published in the German “Ärzteblatt”.
After their infection, patients suffer from symptoms such as
But heart problems, kidney and metabolic disorders can also occur as a result of an infection. The list of possible symptoms is long: in various studies, those affected have given up to 200 different symptoms for Long-Covid.
Experts assume that at least ten percent of all people infected with corona suffer from long-Covid. In a highly topical Long-Covid-Review, which was published in the renowned ” Nature ” magazine on Friday, the researchers estimate that
are affected by Long-Covid.
It also affects all age groups, but an increased percentage of people between the ages of 36 and 50 years. Factors such as previous illnesses, a low socio-economic status and the lack of an opportunity to recover would favor long-Covid.
However: Many people with a mild course also suffer from Long-Covid. “We found that a staggering 90 percent of people living with long-Covid had only mild COVID-19,” researchers Sarah Wulf Hanson and Theo Vos, both from the University of Washington, write in a paper in “The Conversation”.
You and your team examined data from 54 studies with 1.2 million people from 22 countries with symptomatic corona infection (March 2020 to January 2022). By long-Covid they understood symptoms three months after the initial infection, with symptoms lasting at least two months. Their study was published in the Journal of the American Medical Association (“JAMA”).
According to the Robert Koch Institute, the corona hospitalization rate (i.e. people who have to be treated in a hospital) has been constant at around 14 percent since the beginning of November. So 86 percent have a mild course. Even if they are less likely to contract Long-Covid, there are simply many more people affected.
The World Health Organization (WHO) estimates that “10 to 20 percent of those infected with Sars-CoV-2 complain of persistent or newly occurring symptoms over a longer period of time after the acute phase of the infection, which is referred to as post-Covid syndrome (PCS)”. , according to the “Ärzteblatt” report. A similar magnitude was confirmed by British longitudinal studies, which accounted for between 7.8 and 17 percent of long-term sufferers.
The current Nature study assumes that there are at least 65 million people with long-Covid worldwide. However, the actual incidence could be three times as high.
In the “Nature” review, specific figures are given, citing various studies: Twelve weeks after the infection, 32 percent were still suffering from fatigue, and 22 percent were found to have cognitive impairments. 20 to 40 percent of long-Covid patients still complained of shortness of breath and coughing at least seven months after infection.
It is estimated that around half of long-Covid patients meet criteria for ME/CF (chronic fatigue syndrome). Cardiac MRI examinations also showed that 78 percent of corona patients and 58 percent of long-Covid patients had heart failure.
An examination of the heart, lungs, liver, kidneys, pancreas and spleen in over 500 people previously infected with corona showed that 59 percent had single organ damage, and 27 percent had multiple organs affected. “The organ damage suffered by long-Covid patients appears to be permanent,” the researchers comment.
Mental illnesses such as anxiety and depression, on the other hand, normalized over time. This was the result of a study with more than 1.3 million formerly corona infected people. In the case of cognitive impairment (brain fog), seizures, dementia, psychosis and other neurocognitive disorders, the increased risk lasted for at least two years.
The extent to which long-Covid or post-Covid also poses a problem with the omicron variant and all its subtypes cannot yet be answered unequivocally. The “JAMA” study referred to mainly includes people who became infected before omicron dominance. The researchers write that initial studies show a lower risk for omicron. At the same time, due to the easy transferability of the variant, a relatively large number of people were infected.
The disease is still a mystery to experts. But the authors of the “Ärzteblatt” report give good evidence for different overarching and organ-specific causes.
One of the reasons why Corona hits so many organs is that Sars-CoV-2 binds to the ACE2 receptor. This in turn can be found in many places in the body. namely in
There are four main theses about the overarching causes:
You can read more about this here: How does Long-Covid arise? These are the four most important theses
According to the current state of knowledge, vaccination is associated with a lower risk or a lower probability of long-Covid. Two doses of vaccine appeared to be more effective than one, according to a preprint study now accepted for publication in the journal BMJ.
Figures from the British ” Covid Surveillance Study ” (as of July 2022) also show that for those who have been vaccinated three times, the prevalence of long-term symptoms can be reduced to below or to a maximum of five percent.
The current “BMJ” study found with regard to milder Covid-19 courses: The long-Covid symptoms did not differ significantly depending on whether someone was vaccinated or unvaccinated at the time of infection. But those who were vaccinated had a significantly lower risk of persistent breathing difficulties, according to the study.
It is difficult to predict how many more people will be affected and how many of those already affected will continue to suffer from the long-Covid symptoms. The socio-medical and economic effects are not yet foreseeable, write the experts in the “Ärzteblatt”, “but should be immense”.
Experts were alarmed when it came to the clinical picture ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome): “If you calculate the rates of post-Covid courses determined in various studies that meet the ME/CFS diagnostic criteria, If the total population decreases, the number of people affected by ME/CFS in Germany must be expected to at least double in the next few years,” write Carmen Scheibenbogen, head of the Charité Fatigue Center at the Charité, and Herbert Renz-Polster, pediatrician and scientist, in their review in “Die Innere Medizin” . According to estimates, around 250,000 to 300,000 people in Germany are already affected. So far it is unknown how many have been added by Corona.
Against this background, the medical profession demands: For clinical care, specialized centers are needed at maximum care facilities (usually university hospitals), in which specialists from several disciplines can offer comprehensive care.