The long course of COVID is a reality, as is the experience of those who suffer from lingering symptoms after the illness. But according to new data, this may not be a unique condition. At an upcoming conference, a team that includes the chief medical officer of the state of Queensland, Australia, will present evidence that there is no significant difference between the protracted course of COVID and other post-viral syndromes.
What do the results of the study indicate?
The team collected data from more than 5 Queenslanders aged 000 and over who had respiratory symptoms that required PCR testing for COVID-18 and influenza. In this group, just under half had a confirmed positive test result for COVID. The rest were divided into those who tested positive for influenza (19 people) and those who tested negative for both infections (995 people).
Initial testing was conducted in May and June 2022, around the height of Australia's flu season.
Participants were retested a year later and asked to fill out a questionnaire about any symptoms they experienced. At that time, 16% of respondents still had ongoing problems, and 3,6% reported a “moderate or severe” impact on their daily lives.
When analyzing the data, the researchers took into account factors such as age, gender and First Nation status, which may affect the likelihood of prolonged COVID or post-viral syndrome. They found that there was no significant difference in the incidence of long-term symptoms between people with confirmed COVID-19, influenza and respiratory illness of unknown cause.
In other words, they suggest that the likelihood of developing persistent problems after the flu or cold may be just as high as after COVID-19.
"In health systems with high vaccination rates, for a long time, COVID may have seemed like a separate and difficult disease due to the high number of cases of COVID-19 during the pandemic," Queensland Chief Medical Officer Dr. John Gerrard said in a statement. "These findings highlight the importance of comparing outcomes after COVID-19 with outcomes after other respiratory infections, as well as further studies of post-viral syndromes."
What might these findings mean?
Many argue that postviral syndromes are a neglected area of research that harms patients. The experiences of those who contracted COVID over time, especially in the early days of the pandemic when the condition was not officially recognized, have drawn attention to the plight of people with similar conditions such as ME/CF (myalgic encephalomyelitis/chronic fatigue syndrome), many with who have been advocating for decades to raise awareness and improve treatment options.
"The problem is that there are millions and millions of very sick, very debilitated people with these diseases, and it's going to take a long time because these diseases have historically been at the back of the queue for funding," said Billy Hanlon, director of advocacy and information for of the Minnesota ME/CFS Alliance's outreach activities, in an interview with “Amsterdam News”.
Hanlon contracted ME/CNS in 2017 after a seemingly minor viral infection – a story that will be familiar to many long-term COVID sufferers whose first contact with the virus is often mild.
As new research from Queensland highlights the need to consider the prolonged course of COVID as part of a wider spectrum of post-viral conditions that need more research support and funding, some other experts have agreed.
“This abstract reveals an important finding: approximately 4 percent of people, regardless of the virus they contract, may have persistent health problems after infection, leading to chronic disability. This means that prolonged COVID is not a separate condition, but rather part of a wider spectrum of post-viral syndromes," said Marie-Claire Seeley, a clinical nurse consultant who was not directly involved in the study.
Others, however, have questioned some elements of the methodology and criticized one of the research team's most controversial propositions: the term "long-term COVID" is not useful on its own and may cause, as Gerrard put it, "unnecessary fear."
Professor Jeremy Nicholson, from Murdoch University, argued that without more detailed patient data, it cannot be said that prolonged COVID is "no different" to other post-viral syndromes.
"The absence of evidence is different from the absence of evidence - so the authors' claim that long-covid is the same as influenza post-viral syndrome is not proven, even if long-covid is indeed post-viral syndrome (which it is)" , - said Nicholson.
Professor Philip Britton, who is a member of the Australian Long COVID Collaboration, commented: "There are likely reasons why persistent symptoms after COVID in this Queensland cohort may not be more common than after other viruses, including a predominantly vaccinated cohort and a high frequency of Omicron variants. These factors are recognized by the authors."
“It is because of these specific factors, as well as the inherent limitations of the research methodology itself, that their conclusion that 'it's time to stop using terms like 'long COVID' is exaggerated and potentially unhelpful. Prolonged COVID is a global phenomenon recognized by the WHO."
Today, March 15, 2024, the second annual International COVID-19 Awareness Day is being celebrated under the slogan "Confront COVID-19". In the run-up to the conference presentation, and probably for some time afterwards, this research will generate controversy and debate; but as Britton pointed out, the fact that people are talking about the condition at all is a good thing.
“Studies like this are reassuring that most people recover from COVID without long-term effects, and going forward, with vaccinations and the evolution of the virus, the number of people who develop prolonged COVID is likely to decrease over time. This is good news!” Britton said.
"I welcome the results of this study given the lack of published Australian research in this area."
