1 in 10 has long-term symptoms from COVID-19 even after 8 months

One in ten people still experienced at least one moderate-to-severe COVID-19 symptom even 8 months after a mild COVID-19 illness, and these symptoms reportedly had negative impact on their home, work, or social life, according to the COMMUNITY* study.

“Despite the fact that the study participants had a mild COVID-19 infection, a relatively large proportion report long-term symptoms with an impact on quality of life,” said lead author Dr Sebastian Havervall from Danderyd Hospital at Karolinska Institute, Stockholm, Sweden.

“The predominant long-term symptoms are loss of smell and taste. Fatigue and respiratory problems are also more common among participants who have had COVID-19 but do not occur to the same extent,” added study principal investigator Dr Charlotte Thålin, also from Danderyd Hospital.

Comparing seropositive vs seronegative participants, moderate-to-severe symptom lasting for ≥2 months were more common among COVID-19-positive cases than non-case (26 percent vs 9 percent; risk ratio [RR], 2.9, 95 percent confidence interval [CI], 2.2-3.8). [JAMA 2021;doi:10.1001/jama.2021.5612]

Beyond 8 months, significantly more seropositive patients still had at least one moderate-to-severe symptom compared with seronegative participants (15 percent vs 3 percent; RR, 4.4, 95 percent CI, 2.9-6.7).

Among the seropositive patients, the most common moderate-to-severe symptoms which lasted for at least 2 months were anosmia, ageusia, fatigue, and dyspnoea.

Also, seropositive participants were more likely to report that their long-term symptoms have disrupted their work life (8 percent vs 4 percent; RR, 1.8), home life (12 percent vs 5 percent; RR, 2.3), and social life (15 percent vs 6 percent; RR, 2.5).

“A considerable portion of low-risk individuals with mild COVID-19 reported a diversity of long-term symptoms, and that these symptoms disrupted work, social, and home life,” noted Havervall and co-authors. 

In addition, more seropositive than seronegative participants had long-lasting symptoms beyond 8 months and perceived moderate to marked disruption from their long-term symptoms, as measured on the Sheehan Disability Scale (11 percent vs 2 percent; RR, 4.5, 95 percent CI, 2.7-7.3).

“[Nevertheless,] we do not see an increased prevalence of cognitive symptoms such as brain fatigue, memory and concentration problems or physical disorders such as muscle and joint pain, heart palpitations or long-term fever,” said Thålin.

The study involved 2,149 healthcare workers at Danderyd Hospital, of which 323 (median age 43 years, 83 percent women) were seropositive for COVID-19 and 1,072 (median age 47 years, 86 percent women) were seronegative. Their blood samples were collected every four months for long-term immunity after mild COVID-19. All participants self-reported on long-term symptoms and impact on the quality of life using questionnaires.

“In light of [these findings], we believe that young and healthy individuals, as well as other groups in society, should have great respect for the virus that seems to be able to significantly impair quality of life, even for a long time after the infection,” said Havervall.

“[We will] be studying COVID-19-associated loss of smell and taste more closely, and investigate whether the immune system, including autoimmunity, plays a role in post-COVID,” Thålin added.

*COMMUNITY: COVID-19 Biomarker and Immunity study