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Long Covid ‘more likely with five or more symptoms in the first week’



People infected with Covid-19 who develop five or more symptoms in the first week of the infection are more likely to develop long Covid, a study has suggested.

A systematic review of long Covid research, published since January 2020, found that the presence of five symptoms in the first week of acute Covid-19 infection ‘is significantly associated with the development of long Covid, irrespective of age or gender’. 

The research was undertaken by scientists at the University of Birmingham as part of the Therapies for Long Covid (TLC) Study Group and identified the ten most common symptoms of long Covid as fatigue, shortness of breath, muscle pain, cough, headache, joint pain, chest pain, altered smell, diarrhoea and altered taste.

The study, published in the Journal of the Royal Society of Medicine, examined symptom prevalence, complications and management of long Covid in adults with acute infections.  

Whilst people with long Covid experience a wide range of physical and mental or psychological symptoms, the authors identified two symptom clusters of long Covid: those comprising exclusively of fatigue, headache and upper respiratory complaints; and those with multi-system complaints including ongoing fever and gastroenterological symptoms.

Lead author of the study Dr Olalekan Lee Aiyegbusi, from the University of Birmingham, said: ‘There is evidence that the impact of acute Covid-19 on patients, regardless of severity, extends beyond hospitalisation in the most severe cases, to ongoing impaired quality of life, mental health and employment issues.’

The authors report that there are now over 160 million confirmed cases of Covid-19 globally, with one in five people, exhibiting symptoms for 5 weeks or more, while one in 10 can have symptoms lasting 12 weeks or more. 

Dr Aiyegbusi added: ‘People living with long Covid generally feel abandoned and dismissed by healthcare providers and receive limited or conflicting advice. More than one-third of the patients in one of the studies included in the review reported they still felt ill or in a worse clinical condition at eight weeks than at the onset of Covid-19.’

The researchers suggest that patients experiencing long Covid may have a similar disease trajectory to other coronaviruses such as SARS and MERS, where six months after hospital discharge, 25% of patients had reduced lung function. The review highlights the need for ‘resilient healthcare systems’ which will be able to cope with future health challenges.

Co-Principal Investigator Professor Melanie Calvert, said: ‘There is an urgent need for better, more integrated care models to support and manage patients with long Covid to improve clinical outcomes.’

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