August. Jan. 12, 2022 — Hair loss, decreased libido and erectile dysfunction have been added to a well-known set of symptoms associated with long-term COVID-19 in non-hospitalized patients, according to the results of a large study.
Dr. Anuradhaa Subramanian of the Institute of Applied Health Research, University of Birmingham, UK, led the study, which was published online July 25 in Nature Medicine superior.
The team analysed 486,149 adult electronic health records from confirmed COVID patients in the UK, compared with 190 from January 10,000 people with no prior history of COVID from 2020 to April 2021. The researchers closely matched the two groups with respect to demographic, social and clinical characteristics.
Team 62 symptoms were identified, including well-known long-term COVID markers such as fatigue, loss of smell, shortness of breath, and brain fog, as well as hair loss, sexual dysfunction, chest pain, fever, uncontrolled bowel movements and swelling of the extremities.
“These differences in symptoms reported between the infected and uninfected groups persisted even after we accounted for age, gender, ethnic group, socioeconomic status, body mass index, Smoking status, the presence of more than 80 health conditions, and the same symptoms reported in the past,” Subramanian and co-investigator Dr. Shamil Haroon wrote in the summary of their talk.
They noted that only 20 of the symptoms they identified were included in the World Health Organization’s long-term COVID clinical case definition.
They also found that people who were more likely to have persistent symptoms 3 months after contracting COVID were also more likely to be younger, female, smokers, belong to certain minority groups , and low socioeconomic status. They are also more likely to be obese and have a variety of health conditions.
One reason they look younger is that people are more likely to have long-term symptoms of COVID, and it could be that older people with COVID are more likely hospitalized and were not included in this study.
“Because we only considered non-hospitalized adults, the older adults included in our study were likely to be relatively healthier and therefore have a lower symptom burden,” he said.
Subramania noted that older patients were more likely to have reported persistent symptoms associated with COVID in the study, but when the researchers took into account a variety of other pre-infection conditions in patients (usually more commonly in older adults), they found younger age to be a risk factor for long-term COVID-related symptoms.
During the study period, the majority of patients were unvaccinated and the results preceded the broad Delta and Omicron variants.
More than half (56.6%) of patients infected with the virus that causes COVID were diagnosed in 2020 and 43.4% in 2021. Fewer than 5% (4.5%) of patients were infected with the virus, and 4.7% of patients with no documented evidence of COVID infection received at least a single dose of the COVID vaccine before the study began.
Eric Topol, MD, founder and director of the Scripps Research Translational Institute in La Jolla, CA, and Medscape The editor-in-chief of (WebMD’s medical professional sister site) , said more research needs to be done to determine whether the results Will vary by vaccination status and evolving variants.
But he points out that the study has several strengths: “Hair loss, loss of libido, and difficulty ejaculating are all new symptoms,” and this large and carefully controlled study shows that , these problems are more likely to occur.
Loss of smell – this is not a new observation – remains the most likely risk shown in the study, followed by hair loss, sneezing, difficulty ejaculating, decreased libido; followed by shortness of breath, fatigue , chest pain, hoarseness, and fever associated with dyspnea.
Three major symptom clusters
Given the wide range of symptoms, prolonged COVID may represent a cluster of conditions, the authors write.
They found three main clusters. The largest, about 80 percent of long-term COVID patients in the study, faced a wide range of symptoms, from fatigue to headaches to pain. The second largest group (15%) had symptoms mostly related to mental health and thinking skills, including depression, anxiety, brain fog and insomnia. The smallest group (5%) mainly had respiratory symptoms such as shortness of breath, cough, and wheezing.
Bringing together symptoms is important to begin to understand what causes long-term COVID, says Farha Ikramuddin, MD, a physical therapist and rehabilitation specialist at the University of Minnesota School of Medicine in Minneapolis .
Although the symptoms listed in this article are new in published research, she said , but she must have seen these symptoms in her long-term COVID clinic over time. (The researchers also only used coded health care data, so the symptoms they found were limited, she noted.)
But she also cautioned that when medical When the information was obtained from the records, it was difficult to determine whether members of the control group were truly free of COVID-19. People often test at home or assume they have the virus and don’t get tested, so no information is recorded, she said.
It’s also important to evaluate nonhospitalized patients, she said, because much of the research on long-term COVID has been from hospitalized patients, so little is known about symptoms in people with mild infections.
” said Ikramuddin.
She Said one of the clear messages of the paper is that listening and asking broad questions about symptoms is important for patients with COVID.
“Consultation has also become very important for our patients. In a pandemic,” she said.
It’s also important to do a return-to-work study of long-term COVID-19 patients to understand how many are able to return and at what capacity, Ikramuddin said.