New Post-Acute Symptoms Occur in 14% of Patients With COVID-19
Pharmacists have counseled many patients who are puzzled why new symptoms occurred weeks or even months after their COVID-19 infection appeared to resolve. A new study explains why, noting that 14% of SARS-CoV-2 infection survivors face the issue of post-acute symptoms, and describing how authors identified more than 50 clinical sequelae that occurred. Here is more information.
MINNEAPOLIS, MN – COVID-19 doesn’t always end when the initial illness resolves – or, at least not in a meaningful percentage of novel coronavirus survivors.
A new study finds that 14% of adults with SARS-CoV-2 infection developed at least one new condition that required medical care during the post-acute phase of illness. The report in The BMJ points out that is 5% higher than adults with no coronavirus infection in 2020.
For the study involving OptumLabs and the Harvard T.H. Chan School of Public Health researchers, the post-acute phase was defined in the study as beginning three weeks after initial infection. The study team reports that those conditions involved the heart, kidneys, lungs and liver and also affected mental health. In fact, they identified more than 50 clinical sequelae after the acute phase of SARS-CoV-2 infection using ICD-10 codes.
While risk of new conditions during the post-acute phase of illness was most increased in patients who were older, had pre-existing conditions and hospital admissions for COVID-19, younger, healthier patients weren’t exempt, according to the report.
For the study to evaluate the excess risk and relative hazards for developing incident clinical sequelae after the acute phase of SARS-CoV-2 infection in adults aged 18-65, researchers used several merged data sources from a large U.S. health plan; that included a large national administrative claims database, an outpatient laboratory testing database and an inpatient hospital admissions database.
Included were patients with continuous enrollment in the health plan from January 2019 to the date of a diagnosis of SARS-CoV-2 infection.
Of the 193,113 participants infected with SARS-CoV-2, 14% had at least one new type of clinical sequelae that required medical care after the acute phase of the illness, which was 4.95% higher than in a 2020 comparator group.
“The risk for specific new sequelae attributable to SARS-Cov-2 infection after the acute phase, including chronic respiratory failure, cardiac arrythmia, hypercoagulability, encephalopathy, peripheral neuropathy, amnesia (memory difficulty), diabetes, liver test abnormalities, myocarditis, anxiety, and fatigue, was significantly greater than in the three comparator groups (2020, 2019, and viral lower respiratory tract illness groups) (all P<0.001),” the authors explained. “Significant risk differences because of SARS-CoV-2 infection ranged from 0.02 to 2.26 per 100 people (all P<0.001), and hazard ratios ranged from 1.24 to 25.65 compared with the 2020 comparator group.”
Researchers urge healthcare professionals to recognize the greater risk for incident sequelae after the acute phase of SARS-CoV-2 infection to help them in planning. They also caution that "the number of survivors with potential sequelae after covid will continue to grow."
In a linked editorial, Elaine Maxwell at the National Institute for Health Research, advises, "Healthcare professionals should be alert to the possibility of long covid in anyone with confirmed or suspected covid-19. How to treat these longer-term consequences is now an urgent research priority.”
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