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People with five or more symptoms in first week of infection more likely to develop long COVID

The presence of more than five symptoms of COVID-19 in the first week of infection is significantly associated with the development of long COVID, irrespective of age or gender, according to a new review published by the Journal of the Royal Society of Medicine.

The review by the University of Birmingham-led Therapies for Long COVID (TLC) Study Group, summarises current research on symptom prevalence, complications and management of long COVID. Pooled prevalence data in the review highlights the ten most common symptoms of long COVID. These are fatigue, shortness of breath, muscle pain, cough, headache, joint pain, chest pain, altered smell, diarrhoea and altered taste.

The researchers identified two main symptom clusters of long COVID: those comprising exclusively of fatigue, headache and upper respiratory complaints; and those with multi-system complaints including ongoing fever and gastroenterological symptoms.

Lead author Dr Olalekan Lee Aiyegbusi, Deputy Director at the University of Birmingham’s Centre for Patient Reported Outcomes Research (CPROR), said: “There is evidence that the impact of acute COVID-19 on patients, regardless of severity, extends beyond hospitalisation in the most severe cases, to ongoing impaired quality of life, mental health and employment issues. People living with long COVID generally feel abandoned and dismissed by healthcare providers and receive limited or conflicting advice. More than one-third of the patients in one of the studies included in the review reported they still felt ill or in a worse clinical condition at eight weeks than at the onset of COVID-19.”

Dr Shamil Haroon, Clinical Lecturer in Primary Care and co-Principal Investigator of the University of Birmingham NIHR/UKRI funded TLC Study, further commented: “Neither the biological or immunological mechanisms of long COVID, nor the rationale for why certain people are more susceptible to these effects, are yet clear, limiting development of therapies. It is essential we act quickly to address these issues.”

In a comparison with other coronaviruses, the researchers suggest that in the longer term, patients with long COVID may also experience a similar disease trajectory to that of patients who had SARS or MERS, pointing to analysis showing that six months after hospital discharge, approximately 25% of patients hospitalised with SARS and MERS had reduced lung function and exercise capacity.

TLC Study’s Co-Principal Investigator Melanie Calvert, Professor of Outcomes Methodology at the University of Birmingham and NIHR Senior Investigator, said: “The wide range of potential symptoms and complications patients with long COVID may experience highlights the need for a deeper understanding of the clinical course of the condition. There is an urgent need for better, more integrated care models to support and manage patients with long COVID to improve clinical outcomes.”

Notes to editors

Symptoms, complications and management of long COVID: a review (DOI: 10.1177/01410768211032850) by Olalekan Lee Aiyegbusi, Sarah E Hughes, Grace Turner, Samantha Cruz Rivera, Christel McMullan, Joht Singh Chandan, Shamil Haroon, Gary Price, Elin Haf Davies, Krishnarajah Nirantharakumar, Elizabeth Sapey and Melanie J Calvert; on behalf of the TLC Study Group, will be published by the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Friday 16 July 2021.

The link for the full text of the paper is: https://journals.sagepub.com/doi/full/10.1177/01410768211032850

For more information about the University of Birmingham-led TLC Study please visit: https://www.birmingham.ac.uk/research/quest/21st-century-healthcare/long-covid.aspx

For further information or a copy of the paper please contact:

Rosalind Dewar
Media Office, Royal Society of Medicine
DL: +44 (0) 1580 764713
M: +44 (0) 7785 182732
E: media@rsm.ac.uk

To arrange media interviews with Dr Shamil Haroon, Dr Lee Aiyegbusi or Professor Melanie Calvert, please contact Emma McKinney, Media Relations Manager (Health Sciences), University of Birmingham, via e.j.mckinney@bham.ac.uk or Tel: +44 7815607157

The Journal of the Royal Society of Medicine (JRSM) is a leading voice in the UK and internationally for medicine and healthcare. Published continuously since 1809, JRSM features scholarly comment and clinical research. JRSM is editorially independent from the Royal Society of Medicine, and its editor is Dr Kamran Abbasi.

JRSM is a journal of the Royal Society of Medicine and it is published by SAGE Publishing.

Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 1000 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company’s continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne. www.sagepublishing.com

The University of Birmingham is ranked amongst the world’s top 100 institutions, and its work brings people from across the world to Birmingham, including researchers and teachers and more than 6,500 international students from nearly 150 countries.

The mission of the National Institute for Health Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high quality, timely research that benefits the NHS, public health and social care;
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  • NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.
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