Nature Medicine and The British Medical Journal (BMJ): Published July, 2022

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with a range of persistent symptoms impacting everyday functioning, known as post-COVID-19 condition or long COVID.

People experiencing long covid have reported a wider set of symptoms than previously thought, including hair loss and sexual dysfunction.

Researchers analyzed primary care data from the United Kingdom to identify symptoms and risk factors for long COVID.

Long COVID has been described as a “pandemic within the pandemic,” with studies suggesting as many as 40 per cent of those infected with COVID-19 could develop persistent symptoms long after the initial illness.

After contracting SARS-CoV-2, around 10% of people develop long COVID, or persistent and relapsing symptoms 4-12 weeks after infection.

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Electronic health records of 2.4 million people in the UK from January 2020 to April 2021 were analysed for a study published in Nature Medicine. The cohort included 486 149 people with confirmed SARS-CoV-2 infection who were not admitted to hospital, matched with a control group of 1.9 million people with no recorded evidence of coronavirus infection.

Authors found 62 symptoms of long COVID, including hair loss, and reduced libido, as well as several risk factors such as smoking or being socially deprived.

Authors concluded that SARS-CoV-2 infection is linked to various symptoms associated with socio-demographic and clinical risk factors.

The symptoms this study identified should help clinicians and clinical guideline developers to improve the assessment of patients with long term effects from covid-19 and to subsequently consider how this symptom burden can be best managed.

62 long COVID symptoms

For the study, the researchers examined primary care data collected between January 31, 2020 and April 15, 2021 from 486,149 adults with a confirmed COVID-19 diagnosis and 1,944,580 controls with no history of SARS-CoV-2 infection.

The participants were matched for sociodemographic characteristics, including smoking status, body mass index (BMI), and comorbidities at baseline.

After adjusting for demographic factors, the researchers found that 62 symptoms were linked to a history of SARS-CoV-2 infection.

The most common symptoms, including new additions, were:

• anosmia (loss of smell)
• hair loss
• sneezing
• ejaculation difficulty
• reduced libido
• shortness of breath at rest
• fatigue
• pleuritic chest pain
• hoarse voice
• fever

The researchers were further able to cluster these symptoms into three main groups:

• A broad spectrum of symptoms, including pain, fatigue, and rash— 80%
• Respiratory symptoms, including cough, shortness of breath, and phlegm— 5.8%
• Mental health and cognitive symptoms including anxiety, depression, insomnia, and brain fog— 14.2%

They also found that long COVID symptoms were more pronounced during the second wave than in the first wave. Whereas COVID-19 diagnosis was linked to a 28% relative increase in reporting cough after 12 weeks during the first wave, it was linked to a 77% relative increase during the second wave.

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