Rethinking long COVID

New research presented at the European Congress of Clinical Microbiology and Infectious Diseases sheds light on the phenomenon of long COVID, particularly in a highly vaccinated population like Queensland, Australia. Contrary to popular belief, the study suggests that long-term COVID may not be as distinctive as previously thought and could resemble post-viral syndromes associated with common respiratory illnesses like influenza.

A study, conducted by Queensland Health researchers, focused on individuals aged 18 and above who experienced symptoms consistent with respiratory illness between May and June 2022. They surveyed a total of 5,112 people, including those with confirmed COVID-19 (2,399 adults), those with influenza (995 adults), and those who tested negative for both viruses but exhibited symptoms (1,718 adults). A year later, in May and June 2023, participants were asked about ongoing symptoms and functional limitations. Surprisingly, the results showed that 16% of respondents reported persistent symptoms a year after their initial illness, with 3.6% experiencing moderate-to-severe functional impairment.

However, after adjusting for factors like age, sex, and First Nation status, there was no significant difference in functional limitations between COVID-19-positive individuals and those who tested negative for COVID-19 or had influenza. Moreover, the study highlighted that older adults and those experiencing symptoms such as dizziness, muscle pain, shortness of breath, post-exertional malaise, and fatigue were more likely to report functional impairment.

This suggests that a variety of factors other than the initial viral infection may affect the long-term COVID impact. Dr. John Gerrard, Queensland's Chief Health Officer, emphasised that the rates of ongoing symptoms and functional impairment associated with COVID are similar to those observed with other respiratory infections. He suggested that the term "long COVID" might inaccurately convey a sense of uniqueness or exceptionalism about the condition, potentially causing unnecessary fear and hypervigilance.

The findings also underscored the importance of comparing post-COVID-19 outcomes with those of other respiratory infections and conducting further research into post-viral syndromes. Dr. Gerrard proposed reconsidering the use of the term "long COVID," as it may inadvertently contribute to misconceptions about the condition.

In summary, the study suggests that in highly vaccinated populations like Queensland, the impact of long-term COVID may be more influenced by the sheer number of COVID-19 cases than the severity of symptoms. This challenges previous assumptions about the distinctiveness of long COVID and calls for a broader understanding of post-viral syndromes. Further research is needed to unravel the complexities of long-term COVID-19 effects and improve patient care and management.