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A corona infection can have serious long-term health consequences. But who will get it? And can that be foreseen in advance?
A British research team examined this question in more detail and published their results on March 10 in the journal “Nature Medicine.”
According to this, the probability of “prolonged covid” increases if more than five symptoms appear in the sick person during the first week of illness.
13 percent still have symptoms after more than a month.
For their study, the scientists tracked the symptoms and course of 4,182 corona patients from Britain, the United States and Sweden. Patients reported their symptoms themselves through an app.
The result: about 13 percent still had symptoms one month after the onset of the disease, 4.5 percent had symptoms for eight weeks or more. Another 2.3 percent were still struggling with the long-term effects of Covid 19 disease even after three months.
The researchers also found that long-term effects were more common in women than men and became more likely with age and higher body mass index.
These six symptoms could be warning signs
The acute symptoms most closely related to the subsequent risk of prolonged covid were fatigue, headache, shortness of breath, hoarseness, and muscle weakness. In corona patients older than 70 years, olfactory disorders were also added as a possible early warning.
Based on the number of symptoms in the first week of illness, the age and sex of the patients, the research team developed a prognostic model to predict long Covid cases.
This model was tested in more than 2,400 crown patients. The hit rate was around 75 percent, as the scientists report.
Expert critically assesses the British study
However, Professor Tobias Welte, pulmonologist and director of the Covid Convalescent Outpatient Clinic at the Hanover School of Medicine (MHH), is skeptical that these six early features of the disease can be used to predict potential long-term consequences. .
“When you look at the symptoms, you see that they are not very specific. Headaches and tiredness can be the result of many living conditions and are not necessarily due to Covid disease. “
On the other hand, there is the problem with Long Covid that you have to distinguish between two groups, according to the expert.
“A group of patients undergo structural organ changes in the lungs or in the heart, which is much less common. This affects approximately ten percent of Long Covid patients. The second group, much more numerous, on the contrary, suffers from a very nonspecific symptom complex, which we call the fatigue complex and which can also be read in the British study. However, I find it difficult to predict Long Covid cases based on these symptoms in the early stage of the disease. Because we see that not all patients with these symptoms also develop long-term effects. ”
Risk based on age and sex?
Professor Welte, who is investigating the long-term effects of corona on MHH, also disagrees with the British researchers’ findings on another point: that the likelihood of prolonged covid increases with age.
“We see very clearly that young people in particular suffer the long-term effects, who as a rule were not seriously ill before. I imagine that the study does not differentiate between the elderly who suffer structural damage, that is, organ damage after a serious illness, and those who struggle with the nonspecific symptom complex. And the first thing should be removed from the equation. “
The fact that women, on the other hand, are disproportionately affected appears to be true against them and has already been proven in several studies.
Prof. Welte: “It is a little crazy with Covid-19. Because although men are twice as likely to become seriously ill and die, women are three times more at risk of long-term effects. This could be due to the fact that the male and female immune systems are genetically completely different, which is also evident in other diseases. “
And hormonal influences could also play a role that, in interaction with the immune system, better protects women against illness and death, but puts them at a disadvantage in terms of long-term consequences, he suspects.
No billing option for long-term Covid patients
According to Welte, about one percent of all corona patients continue to complain of symptoms after surviving the viral illness, a number that worries the pulmonologist in light of the large and growing number of Covid patients.
“The clinical picture that Long Covid patients develop is not new in itself; We also know it from other viral diseases such as influenza or Pfeiffer’s glandular fever. However, the problem is that there are hardly any contact points for these patients. Our outpatient clinic is one of the few in Germany and is funded solely by donations. “
In addition, the payment is not regulated at all, since there is still no billing number for these cases, criticizes Welte. “That will become more and more of a problem, because Long Covid patients exist and will sadly continue to exist.”
