The Latest on Long COVID — Most Prevalent Symptoms to Research Underway | IDWeek 2023

The investigation to understand Long COVID, or post-acute sequelae SARS-CoV-2 infection (PASC), is still on-going.

However, at this year’s ID Week conference in Boston, Igho Ofotokun, MD, MSc, FIDSA, Grady Distinguished Professor of Medicine at the Emory University School of Medicine, shared the latest data that COVID-19 research team, RECOVER, has gathered on Long COVID and its symptoms.

Ofotokun is chair of the RECOVER (Researching COVID to Enhance Recovery in adults) committee, which focuses on understanding the incidence, prevalence, clinical symptoms, organ dysfunction, natural history and biological mechanisms of sequelae of SARS-CoV-2 infection.

One of the recent studies Ofotokun presented and conducted by RECOVER was an ambi-directional longitudinal meta-cohort study, including individuals with and without COVID-19 of all ages and ethnicities. The study followed patients from one year into their COVID infection up to month 48.

Researchers made sure “the population groups affected the most were represented in the study,” Ofotokun said.

The participants were categorized into three tiers based on acute and post-acute symptoms, with standardized testing varying across the tiers.

In another study within RECOVER’s initiative earlier this year, approximately 9,764 participants were included to develop a definition of Long COVID.

Using a 3-step analysis, researchers identified 12 common symptoms associated with Long COVID, which included post-exertional malaise, fatigue, brain fog, dizziness, GI symptoms, palpitations, sexual desire or capacity, smell or taste issues, thirst, chronic cough, chest pain, and abnormal movements.

Key findings from this study revealed an estimated prevalence of Long COVID in the overall population of roughly 10%. Positivity for Long COVID was more common and associated with more severe manifestations in participants infected in the pre-Omicron era.

Additionally, fully vaccinated individuals showed a lower proportion of Long COVID positivity compared to unvaccinated participants.

Lastly, PASC positivity was more common among those who were reinfected compared to those with one reported infection, indicating a link between reinfections and Long COVID.

The electronic health record was also a component of RECOVER’s research.

EHRs have collected data from over 14 million individual patients and helped define clusters of Long COVID, revealing that it is not a homogeneous disease, Ofotokun shared.

Six different clusters were identified, relating to the prevalence of symptoms in different organ systems, including neurologic, metabolic and obesity-related, cardio, and more.

Ofotokun expressed there are ongoing analyses by RECOVER with around 40 independent studies planned.

Researchers are exploring sex differences in Long COVID, refining the definition by adding clinical risk and laboratory findings, and aligning findings from electronic health records with prospective observational studies, he added.

Additionally, investigations into Long COVID in different population groups across the lifespan, including pediatric, pregnant, and aging populations, are underway.

The understanding of Long COVID is expanding, with a high estimated prevalence of 10% or higher and the involvement of almost every organ system, RECOVER research found.