A conceptual framework to accelerate the clinical impact of evolving research into long COVID

• Published in: The Lancet infectious diseases 2021-06, Vol.21 (6), p.756-757
• Main Authors: Kondratiuk, Alexandra L, Pillay, Timesh D, Kon, Onn Min, Lalvani, Ajit
• Format: Article
• Language: English
• Subjects: Biomedical Research - statistics & numerical data; Biomedical Research - trends; Comment; Coronaviruses; Cough; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; COVID-19 - physiopathology; Forecasting; Humans; Illnesses; Infections; Infectious diseases; Intensive care; Long COVID; Long Term Adverse Effects - physiopathology; Medical research; Myalgia; Olfaction; Pandemics; Pathology; Patients; Public health; Rehabilitation; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Signs and symptoms; Smell; United Kingdom - epidemiology; Viral diseases
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(21)00136-5

With more than 122 million cases of COVID-19 reported globally, and with a growing second pandemic wave underway, the long-term consequences of COVID-19 are an urgent public health priority.1 An international survey of individuals with so-called long COVID reported a wide range of symptoms that persisted for months and resulted in substantial disability.2 Latest UK estimates from an unweighted sample of 9063 individuals with COVID-19 suggest that 22% of individuals still have symptoms 5 weeks after initial infection, and 10% still have symptoms at 12 weeks.3 People with long COVID have struggled to be heard, and it is encouraging that the scientific and medical communities are finally listening. In the UK, a five-point National Health Service plan has allocated £10 million to support sufferers of long COVID through specialist clinics and an online rehabilitation service, alongside £20 million for National Institute for Health Research (NIHR)-funded research.4 Although, for any positive therapeutic relationship, it is essential that clinicians listen to their patients, this alone is rarely sufficient to treat symptoms. The most common symptoms of long COVID include fatigue, breathlessness, cough, loss of taste or smell (or both), myalgia, and gastrointestinal disturbance.2,3,6,7 Persistent symptoms seem more likely to occur after severe disease than after non-severe disease, with the people who had intensive care unit treatment reporting the most pronounced symptoms in the convalescent period.8 However, even individuals with mild COVID-19 report pronounced symptoms weeks or months after acute disease.3,7 Persistent symptoms have been associated with evidence of multi-organ damage, even in young, low-risk populations;9 however, only a small proportion of these symptoms are currently accounted for pathologically.