Brain fog and tinnitus among 200 symptoms of long Covid (paywalled)
Long Covid has more than 200 symptoms that affect ten organ systems, the biggest international study of “long-haulers” suggests.
British health experts are calling for a nationwide screening program to help to identify the condition in people who may be suffering in silence.
The study, led by University College London (UCL), has identified 203 symptoms affecting the organs, with 66 lasting up to seven months.
The most common symptoms reported by almost four thousand sufferers of long Covid were fatigue, brain post-exertional malaise - where symptoms worsen after physical or mental exertion - and cognitive dysfunction, often called “brain fog”.
Other symptoms included hallucinations, tremors, itchy skin, changes to the menstrual cycle, sexual dysfunction, heart palpitations, bladder control issues, shingles, memory loss, blurred vision, diarrhoea and tinnitus.
The research team, who have all had or continue to have long Covid, are calling for clinical guidelines on assessing the condition to be significantly widened. Clinicians test heart and breathing function but the researchers say that neuropsychiatric, neurological and activity intolerance symptoms need to be included.
A national screening program should also be made accessible to anyone who thinks they have long Covid to address the large number of long-haulers who are “suffering in silence”, the authors say.
More than two million adults in England have experienced coronavirus symptoms lasting more than 12 weeks, government data suggests - double the previous estimate for long Covid.
The study, in the EClinicalMedicine journal published by The Lancet, involved 3,762 participants from 56 countries who connected through the Body Politic online Covid-19 support group. They answered a survey designed to profile the symptoms and period of time patients had confirmed or suspected long Covid, including the impact on daily life, work, and return to health. Of the 3,762 respondents, 3,608 (96 per cent) reported symptoms beyond 90 days, 2,454 experienced symptoms for at least six months and 233 had recovered after seven months.
Eighty-nine per cent of participants experienced relapses, with exercise, physical or mental activity and stress as the main triggers. Forty-five per cent reported requiring a reduced work schedule and 22 per cent were not working at all at the time of the survey. The three most debilitating symptoms listed by patients were: fatigue (2,652 patients), breathing issues (2,242) and cognitive dysfunction (1,274).
Dr Athena Akrami, a neuroscientist at the Sainsbury Wellcome Centre at UCL and senior author, said: “We have gone directly to ‘long-haulers’ around the world in order to establish a foundation of evidence for medical investigation, improvement of care, and advocacy for the long-Covid population. For the first time this study shines a light on the vast spectrum of symptoms, particularly neurological, prevalent and persistent in patients with long Covid.
“Along with the well-documented respiratory and cardiovascular symptoms, there is now a clear need to widen medical guidelines to assess a far wider range of symptoms.
“Furthermore, there are likely to be tens of thousands of long-Covid patients suffering in silence, unsure that their symptoms are connected to Covid-19. Building on the network of long-Covid clinics, which take GP referrals, we now believe a national program could be rolled out into communities able to screen, diagnose and treat all those suspected of having long-Covid symptoms.”