HTB

Long COVID: Mild infection and sustained long-term complications

Simon Collins, HIV i-Base

Although most COVID-19 studies focus on people hospitalised with severe infection, complications have also been associated with mild infection. 

So while many infections have symptoms that resolve within 3 weeks, up to 10% of cases might take more than four weeks and include symptoms that fall short of needing to be hospitalised but by reducing daily activities, challenge the category of being mild.

This was the subject of a BMJ editorial written from experience of a longer mild infection. [1]

Common symptoms still include fatigue, chest pain and shortness of breath that limit exercise, even in people who were fit before infection and the article stresses the need to measure recovery and time to recovery in greater detail for all stages than just by mortality and time to discharge from hospital.

This is also relevant for the longer recovery times that are already recognised as a complication from more severe stages of COVID-19.  

Several UK support groups report having >12,000 members.

The BMJ published a related podcast on post-acute and chronic COVID-19 to support management in primary care. [4]

A 29-page NIHR review also looks a personal experiences of COVID-19 including the increasing reports of long-term symptoms and how to mange them. [5]

A useful related article on recovery from severe COVID-19 was also recently published in JAMA. [6]

References

  1. Alwan NA. What exactly is mild covid-19? BMJ (28 July 2020).
    https://blogs.bmj.com/bmj/2020/07/28/nisreen-a-alwan-what-exactly-is-mild-covid-19
  2. Long COVID website
    https://www.longcovid.org
  3. Body Politic website
    https://www.wearebodypolitic.com/covid19
  4. Management of post-acute covid-19 in primary care. BMJ 2020; 370 doi:10.1136/bmj.m3026. (11 August 2020).
    https://www.bmj.com/content/370/bmj.m3026
  5. NIHR. Living with COVID-19. (19 October 2020).
    https://evidence.nihr.ac.uk/themedreview/living-with-covid19
  6. Prescott HC et al. Recovery from severe COVID-19: leveraging the lessons of survival from sepsis. JAMA. 2020;324(8):739-740. DOI:10.1001/jama.2020.14103. (5 August 2020).
    https://jamanetwork.com/journals/jama/fullarticle/2769290

Links to other websites are current at date of posting but not maintained.