Keila Maia (Fiocruz Minas)
Half the people diagnosed with COVID-19 present sequelae that may last for more than a year. This is one of the conclusions of a longitudinal study developed at Fiocruz Minas, which evaluated the effects of the disease over time. The research followed, for 14 months, 646 patients who had had the infection, and verified that 324 of them, that is, 50.2%, had post-infection symptoms, characterizing what the World Health Organization (WHO) classifies as long COVID. The study was published in Transactions of The Royal Society of Tropical Medicine and Hygiene.
Overall, the research listed 23 symptoms after the acute infection was over. Fatigue, characterized by intense tiredness and difficulty carrying out everyday chores, is the main complaint, reported by 115 people (35.6%). The most commonly mentioned sequelae include persistent cough (110; 34%), difficult breathing (86; 26.5%), loss of the sense of smell or taste (65; 20.1%), and frequent headaches (56; 17.3%). Mental issues are also worthy of mention, such as insomnia (26; 8%), anxiety (23; 7.1%), and dizziness (18; 5.6%). Patients also mention more severe sequelae, such as thrombosis, diagnosed in 20 patients, that is, 6.2% of the monitored population.
According to researcher Rafaella Fortini, who coordinates the study, all reported symptoms began after the acute infection, and many persisted throughout the 14 months, with some exceptions, such as thrombosis, from which, having been adequately treated with proper medical interventions, patients recovered after five months. “We have cases of people who are still being monitored, as the symptoms have remained even after the 14 months. We also observed that the presence of seven comorbidities, including chronic hypertension, diabetes, cardiopathies, cancer, chronic obstructive pulmonary disease, chronic kidney disease, and smoking or drinking resulted in more severe acute infection and increased the chance of having sequelae”, she explained.
The results of the study also showed that the post-infection symptoms manifest in the three forms of the disease: severe, moderate, and mild. In the severe form, of a total of 260 patients, 86 (33.1%) had long-lasting symptoms. Among the 57 patients diagnosed with the moderate form of the disease, 43 (75.4%) reported sequelae. Of the 329 patients who had mild COVID, 198 (59.3%) had symptoms months after the acute infection was over. “These results show the importance of understanding these sequelae well, as they are affecting even people who were asymptomatic during the acute phase of the infection”, highlights the researcher.
The research followed patients who had received care at the emergency room of Hospital da Baleia and Hospital Metropolitano Dr. Célio de Castro, both reference institutions for COVID-19 in Belo Horizonte. Patients sought medical help between April 2020 and March 2021. They were all tested through RT-qPCR and received a positive diagnostic for COVID-19.
The remaining symptoms and sequelae were monitored through monthly interviews, either in person or using an online platform, over 14 months after the confirmation diagnosis, in the period between March 2020 and November 2021. The age of the participants ranged between 18 and 91 years; 53.9% were female. Of the 646 patients followed by the study, only five had been vaccinated. Of these five, three had long COVID.
According to researcher Rafaella Fortini, the data obtained from the study allow a better understanding of the long-term effects of COVID-19. “This is a complex disease that can affect different organs. Obtaining information is crucial to treat them adequately. There is still much to know. Why does it happen? How does it act on our bodies? The answers to these questions will allow us to understand the physiopathology of long COVID, so we can solve these sequelae in the best possible manner”, she said.
Fortini stated that it is important that people seek health services to treat long COVID. “People tend to seek treatment only against the more severe sequelae, like thrombosis However, it is crucial to look for medical help for other issues, as they can also interfere with people’s quality of life in a remarkable manner”, she said.