The risk of long COVID has declined over the course of the pandemic, although it remains a persistent threat. Researchers from Washington University School of Medicine in St. Louis identified vaccination as a primary factor in reducing the risk of long COVID.
According to a report published today by scientists from Washington University School of Medicine in St Louis, the risk of contracting long COVID after an infection with the SARS-CoV-2 virus fell significantly when people were vaccinated. This was true for both the Delta and Omicron strains as well as for original.
The researchers attribute almost 72% of this reduction to the vaccines and the rest to changes in the SARS-CoV-2 virus and improved detection and management of infected patients. Their results are published in the New England Journal of Medicine and in a Washington University School of Medicine new release:
What is long COVID? Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), refers to a range of symptoms that continue for weeks or months after the acute phase of a COVID-19 infection has resolved. These symptoms can persist for a long time and vary widely among individuals.
Key Features of Long COVID
Mechanisms and Treatment
- Duration:
- Symptoms last for more than four weeks after the initial infection.
- Some individuals experience symptoms for several months, with a notable percentage having symptoms lasting a year or more.
- Common Symptoms:
- Fatigue
- Shortness of breath
- Cognitive issues ("brain fog")
- Sleep disturbances
- Joint pain
- Chest pain
- Cough
- Headache
- Palpitations
- Loss of taste or smell
- Affected Systems:
- Respiratory system (e.g., persistent cough, difficulty breathing)
- Cardiovascular system (e.g., heart palpitations, chest pain)
- Nervous system (e.g., cognitive dysfunction, headaches)
- Musculoskeletal system (e.g., joint pain, muscle aches)
- General well-being (e.g., chronic fatigue, sleep problems)
- Risk Factors:
- Severity of initial COVID-19 illness (though even mild cases can lead to long COVID)
- Pre-existing health conditions
- Age (older adults are more at risk, but long COVID can affect people of any age)
- Gender (some studies suggest women may be more prone to long COVID than men)
- Impact:
- Long COVID can significantly affect quality of life, leading to challenges in returning to normal daily activities, work, and social interactions.
- The condition can be debilitating, with some patients experiencing severe limitations in physical and cognitive functions.
- Possible Mechanisms:
- Persistent viral infection or remnants in the body
- Immune system dysregulation
- Inflammation
- Autonomic nervous system dysfunction
- Management and Treatment:
- There is no one-size-fits-all treatment; management is often symptom-specific.
- Rehabilitation and physical therapy can help with physical symptoms.
- Cognitive therapy and support for mental health issues.
- Medications to manage specific symptoms, such as pain relievers for joint pain or medications for sleep disturbances.
Research and Support
Understanding long COVID is crucial as it impacts a significant number of COVID-19 survivors, highlighting the need for continued research and healthcare resources to address this ongoing public health challenge.
- Ongoing research aims to understand the underlying causes of long COVID, identify risk factors, and develop effective treatments.
- Support groups and long COVID clinics have been established to provide comprehensive care and support to affected individuals.
Risk of long COVID declined over course of pandemic
Drop attributed mostly to vaccination but remaining risk still significant
The risk of developing long COVID has decreased significantly over the course of the COVID-19 pandemic, according to an analysis of data led by Washington University School of Medicine in St. Louis.
Researchers attributed about 70% of the risk reduction to vaccination against COVID-19 and 30% to changes over time, including the SARS-CoV-2 virus’s evolving characteristics and improved detection and management of COVID-19.
The research is published July 17 in The New England Journal of Medicine.
The research on declining rates of long COVID marks the rare occasion when I have good news to report regarding this virus. The findings also show the positive effects of getting vaccinated.
Dr Ziyad Al-Aly, MD, Senior author.
Department of Medicine
Washington University School of Medicine (Z.A.-A.),
And the Institute for Public Health,
Washington University in St. Louis, Missouri, USA.
Long COVID encompasses the lingering and debilitating effects on health experienced by about 10% of people who have been infected with COVID-19. To date, the World Health Organization has documented more than 775 million cases of COVID-19.
In more than 30 high-profile studies, Al-Aly has detailed the virus’s indiscriminate, long-term health impacts across nearly all organ systems affecting the heart, brain, kidneys and gastrointestinal (GI) tract.
Although his latest findings sound more reassuring than previous studies, Al-Aly tempered the good news.
Long COVID is not over. We cannot let our guard down. This includes getting annual COVID vaccinations, because they are the key to suppressing long COVID risk. If we abandon vaccinations, the risk is likely to increase.
Dr Ziyad Al-Aly, MD
Since the pandemic’s beginning, Al-Aly has dedicated himself to analyzing long COVID with the aim of helping the public make informed health choices; supporting scientists in generating research-backed recommendations on prevention and treatment; and enabling politicians to make educated decisions regarding funding and public policies. Al-Aly’s latest study builds on this body of work by examining the virus’s variants and overall evolution.
To do this, Al-Aly and his team analyzed millions of de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs, the nation’s largest integrated health-care system. The study included 441,583 veterans with SARS-CoV-2 infections and more than 4.7 million uninfected veterans, from March 1, 2020, through Jan. 31, 2022.
Patients included people of diverse ages, races and sexes; statistical modeling ensured parity in representation.
The researchers divided the veterans into five groups: unvaccinated COVID-19 sufferers who acquired the original strain in 2020; the delta variant in 2021; and the omicron variant in 2022. The other two groups included vaccinated people who had the delta variant, and vaccinated people with omicron. No vaccines existed while the original strain circulated.
The team estimated rates of long COVID one-year postinfection for each of the five groups.
Unsurprisingly, the rate of long COVID was the highest among those with the original strain, Al-Aly said, with 10.4% of those who had infections that developed into long COVID.
s That declined to 9.5% among those in the unvaccinated groups during the delta era and 7.7% during omicron.
Among the vaccinated, the rate of long COVID during delta was 5.3% and 3.5% during omicron.
You can see a clear and significant difference in risk during the delta and omicron eras between the vaccinated and unvaccinated, so, if people think COVID is no big deal and decide to forgo vaccinations, they’re essentially doubling their risk of developing long COVID.
Dr Ziyad Al-Aly, MD
Al-Aly also emphasized that even with the overall decline, the lowest rate — 3.5% — remains a substantial risk.
That’s three to four vaccinated individuals out of 100 getting long COVID. Multiplied by the large numbers of people who continue to get infected and reinfected, it’s a lot of people. This remaining risk is not trivial. It will continue to add an already staggering health problem facing people across the world.
Dr Ziyad Al-Aly, MD
Another notable finding offers clues to the virus’s evolution, Al-Aly added. While analyzing the risk among all people infected with COVID-19 during the omicron era of 2022, the likelihood of heart, brain, kidney and lung problems declined. In contrast, diseases and illnesses associated with metabolic function and the GI system increased.
People tend to think of SARS-CoV-2 as a homogeneous virus, but each variant has its own fingerprint. The original virus hit the respiratory system hard. Omicron targeted metabolic and GI issues. It’s important because while the risk of long COVID is quantitatively lower, a person can be at a higher risk of developing an illness based on the part of the body that the COVID variant targets.
It’s really good news that the risk has declined, but we know millions of people already have long COVID, and millions more will continue to get long COVID. We need to double down on our efforts to understand it so we can prevent suffering and treat affected individuals.
Dr Ziyad Al-Aly, MD
AbstractThere is a clear message here: To reduce the risk becoming seriously ill with COVID-19 and to reduce the risk of the debilitating effects of long COVID, get vaccinated and have regular boosters.
BACKGROUND
Postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) can affect many organ systems. However, temporal changes during the coronavirus disease 2019 (Covid-19) pandemic, including the evolution of SARS-CoV-2, may have affected the risk and burden of PASC. Whether the risk and burden of PASC have changed over the course of the pandemic is unclear.
METHODS
We used health records of the Department of Veterans Affairs to build a study population of 441,583 veterans with SARS-CoV-2 infection between March 1, 2020, and January 31, 2022, and 4,748,504 noninfected contemporaneous controls. We estimated the cumulative incidence of PASC at 1 year after SARS-CoV-2 infection during the pre-delta, delta, and omicron eras of the Covid-19 pandemic.
RESULTS
Among unvaccinated persons infected with SARS-CoV-2, the cumulative incidence of PASC during the first year after infection was 10.42 events per 100 persons (95% confidence interval [CI], 10.22 to 10.64) in the pre-delta era, 9.51 events per 100 persons (95% CI, 9.26 to 9.75) in the delta era, and 7.76 events per 100 persons (95% CI, 7.57 to 7.98) in the omicron era (difference between the omicron and pre-delta eras, −2.66 events per 100 persons [95% CI, −2.93 to −2.36]; difference between the omicron and delta eras, −1.75 events per 100 persons [95% CI, −2.08 to −1.42]). Among vaccinated persons, the cumulative incidence of PASC at 1 year was 5.34 events per 100 persons (95% CI, 5.10 to 5.58) during the delta era and 3.50 events per 100 persons (95% CI, 3.31 to 3.71) during the omicron era (difference between the omicron and delta eras, −1.83 events per 100 persons; 95% CI, −2.14 to −1.52). Vaccinated persons had a lower cumulative incidence of PASC at 1 year than unvaccinated persons (difference during the delta era, −4.18 events per 100 persons [95% CI, −4.47 to −3.88]; difference during the omicron era, −4.26 events per 100 persons [95% CI, −4.49 to −4.05]). Decomposition analyses showed 5.23 (95% CI, 4.97 to 5.47) fewer PASC events per 100 persons at 1 year during the omicron era than during the pre-delta and delta eras combined; 28.11% of the decrease (95% CI, 25.57 to 30.50) was attributable to era-related effects (changes in the virus and other temporal effects), and 71.89% (95% CI, 69.50 to 74.43) was attributable to vaccines.
CONCLUSIONS
The cumulative incidence of PASC during the first year after SARS-CoV-2 infection decreased over the course of the pandemic, but the risk of PASC remained substantial even among vaccinated persons who had SARS-CoV-2 infection in the omicron era. (Supported by the Department of Veterans Affairs.)
From personal experience, the worst you can expect from the vaccine is a slightly sore arm for a couple of days and maybe feeling a bit under the weather for a day or two, which, according to another recent research paper, is probably a sign that the vaccine is working very well and producing a high level of antibodies.
Don't be a COVIDIOT! Get vaccinated and stay boosted! COVID-19 is not going away soon.
Yes we must not let our guard down with this Covid disease. It's not going away sad to say. That absurd charlatan preacher Kenneth Copeland thought he could get rid of this disease by praying and by just saying poof. God doesn't heal pandemics, He allows it. Our hope is with science and medicines. Religion and praying is of no use.
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