by Juliette Dufour
For November 2022, we have selected: Post-acute sequelae of covid-19 six to 12 months after infection: population based study, BMJ, 2022. DOI: 10.1136/bmj-2022-071050
Post-acute health problems and sequelae have been reported in survivors of covid-19. According to a review, up to 80% of patients with covid-19 continue to complain about health problems after acute infection, and more than 50 adverse effects have been reported.
The objective of our paper of the month was to describe symptoms and symptom clusters of post-covid syndrome six to 12 months after acute infection, describe risk factors, and examine the association of symptom clusters with general health and working capacity.
The authors conducted a cross sectional study in southern Germany involving people aged 18–65 who had a SARS-CoV-2 infection between October 2020 and March 2021, confirmed by polymerase chain reaction (PCR) and notified to local health authorities.
They included 11,710 patients in the analysis (mean age 44.1 years old, 58.8% (n=6881) female, mean follow-up time 8.5 months).
This large population-based study found a considerable burden of symptom clusters with possible sequelae six to twelve months after SARS-CoV-2 infection affecting both general health and working capacity. Although a variety of long-lasting complaints was reported, few symptom clusters drove this burden. Fatigue (37.2% (4213/11312)), and neurocognitive impairment (31.3% (3561/11361)), contributed the most to reduced health recovery and working capacity. Chest symptoms, anxiety/depression, headache/dizziness, and pain syndromes were also prevalent and relevant for working capacity, with some differences according to sex (women > men) and age (younger>older patients).
The authors of the month confirm the existence of a considerable burden of self-reported post-acute symptom clusters, notably fatigue and neurocognitive impairment, six to twelve months after acute SARS-CoV-2 infection, even among young adults after mild infection, with a substantial impact on general health and working capacity.
Given the individual and societal burden of post-covid sequelae, the underlying biological abnormalities and causes need clarification to define adequate treatment options and develop effective rehabilitation measures.