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Study Finds 1 in 10 Healthcare Workers with Mild COVID Have Lasting Symptoms

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People showing symtoms of anosmia, fatigue, and ageusia
Credit: Getty Images

It’s become increasingly clear that even healthy people with mild cases of COVID-19 can battle a constellation of symptoms that worsen over time—or which sometimes disappear only to come right back. These symptoms are part of what’s called “Long COVID Syndrome.”

Now, a new study of relatively young, healthy adult healthcare workers in Sweden adds needed information on the frequency of this Long COVID Syndrome. Published in the journal JAMA, the study found that just over 1 in 10 healthcare workers who had what at first seemed to be a relatively mild bout of COVID-19 were still coping with at least one moderate to severe symptom eight months later [1]. Those symptoms—most commonly including loss of smell and taste, fatigue, and breathing problems—also negatively affected the work and/or personal lives of these individuals.

These latest findings come from the COVID-19 Biomarker and Immunity (COMMUNITY) study, led by Charlotte Thålin, Danderyd Hospital and Karolinska Institutet, Stockholm. The study, launched a year ago, enlisted 2,149 hospital employees to learn more about immunity to SARS-CoV-2, the coronavirus that causes COVID-19.

After collecting blood samples from participants, the researchers found that about 20 percent already had antibodies to SARS-CoV-2, evidence of a past infection. Thålin and team continued collecting blood samples every four months from all participants, who also completed questionnaires about their wellbeing.

Intrigued by recent reports in the medical literature that many people hospitalized with COVID-19 can have persistent symptoms for months after their release, the researchers decided to take a closer look in their COMMUNITY cohort. They did so last January during their third round of follow up.

This group included 323 mostly female healthcare workers, median age of 43. The researchers compared symptoms in this group following mild COVID-19 to the 1,072 mostly female healthcare workers in the study (median age 47 years) who hadn’t had COVID-19. They wanted to find out if those with mild COVID-19 coped with more and longer-lasting symptoms of feeling unwell than would be expected in an otherwise relatively healthy group of people. These symptoms included familiar things such as fatigue, muscle pain, trouble sleeping, and problems breathing.

Their findings show that 26 percent of those who had mild COVID-19 reported at least one moderate to severe symptom that lasted more than two months. That’s compared to 9 percent of participants without COVID-19. What’s more, 11 percent of the individuals with mild COVID-19 had at least one debilitating symptom that lasted for at least eight months. In the group without COVID-19, any symptoms of feeling unwell resolved relatively quickly.

The most common symptoms in the COVID-19 group were loss of taste or smell, fatigue, and breathing problems. In this group, there was no apparent increase in other symptoms that have been associated with COVID-19, including “brain fog,” problems with memory or attention, heart palpitations, or muscle and joint pain.

The researchers have noted that the Swedish healthcare workers represent a relatively young and healthy group of working individuals. Yet, many of them continued to suffer from lasting symptoms related to mild COVID-19. It’s a reminder that COVID-19 can and, in fact, is having a devastating impact on the lives and livelihoods of adults who are at low risk for developing severe and life-threatening COVID-19. If we needed one more argument for getting young people vaccinated, this is it.

At NIH, efforts have been underway for some time to identify the causes of Long COVID. In fact, a virtual workshop was held last winter with more than 1,200 participants to discuss what’s known and to fill in key gaps in our knowledge of Long COVID syndrome, which is clinically known as post-acute sequelae of COVID-19 (PASC). Recently, a workshop summary was published [2]. As workshops and studies like this one from Sweden help to define the problem, the hope is to learn one day how to treat or prevent this terrible condition. The NIH is now investing more than $1 billion in seeking those answers.

References:

[1] Symptoms and functional impairment assessed 8 Months after mild COVID-19 among health care workers. Havervall S, Rosell A, Phillipson M, Mangsbo SM, Nilsson P, Hober S, Thålin C. JAMA. 2021 Apr 7.

[2] Toward understanding COVID-19 recovery: National Institutes of Health workshop on postacute COVID-19. Lerner A, et al. Ann Intern Med, 2021 March 30.

Links:

COVID-19 Research (NIH)

Charlotte Thålin (Karolinska Institutet, Stockholm, Sweden)

25 Comments

  • Bruce Roseman, M.D. says:

    I have been using doxycycline as an antiprotease inhibitor in my patients (females 15-25 years old ) who had persistent loss of taste/smell. I treated this group four to six weeks after they had their primary symptoms. All had mild disease. None were hospitalized.

  • Mike Mage says:

    Were the Swedish Health Care Workers tested for infectious virus at various time points after the initial infection?

  • Jennifer Ohayon says:

    Was SARS-CoV-2 RT-PCR diagnostic testing also performed? An additional cohort of healthcare workers that tested SARS-CoV-2 RNA positive, but antibody negative would have been interesting.

  • George Nicolae says:

    Somehow such effects are expected, at one point the virus might be to weak to win the immune system and became stronger in time by some modifications or other effects. We might compare the innitial weak effect with those that were treated with penniciline for some causes but did not finish the treatment and the virus become immune to penniciline. I am chemist and I look at the matters as large molecules with an “atomic conformational steric structure” that at one point might be modified at one point protecting the active area of “neutralization”. It might be very interesting to know if the atomic conformational structure is the same. Based on some of my older studies regarding atomic chemical conformational structure, there is needed just one single atom of Carbon (from an amino-acid) to change the chain with 180 degree orientation, and that make the problems more complex.. It is not easy what you the scientists are doing and also is very exciting to have the tools (toys) to work with to look at the enemies (virus) from all details. Thank you for your post, very interesting and useful to learn and educate.

  • Diana V. says:

    I had covid and am losing hair…..female
    Any advice?

    • Dr Gregory Winterflood says:

      Possibly Telogen effluvium, especially if your hair loss started 1-3 months after the illness. Try Googling Telogen effluvium.

    • April says:

      Are you a member of the long haul COVID survivor group on Facebook? There are thousand of us like you.

  • Jared M Johnson says:

    How do you control for the fact that the study participants knew they had the disease and are now more sensitive to any kind of perceived difference in their well-being?

    • April says:

      “Perceived” difference? Before contracting COVID at work I could run 5 miles/day, walk the golf course, and work 12 hour days as a registered nurse. NOW-I’m in pain 24/7, tinnitus, SOB, gastrointestinal issues, brain issues, dizziness…..the long term effects are not “perceived”, they are REAL and debilitating.

      • SH says:

        I am a doctor. Got COVID at work. Having same debilitating unrelenting symptoms. Still waiting for relief.

  • carol g says:

    My son had covid (didn’t go to hosp) & the vaccines. He has ongoing fatigue & breathing problems. He has a lot of mucus that he can’t get rid of. He was retested & it is negative. What can he do? He is 58.

  • Mike W says:

    I am encouraged by stories like this, until I read that there is no mention of the long-haul mental health issues from COVID-19 infections. A recent British study found that 1 in 3 COVID survivors will experience neurological or psychological sequelae, including depression, anxiety, encephalopathy and/or post-COVID psychosis. As yet, I have not seen NIH or NIMH take any kind of national leadership on the long-haul mental health crisis, and I am severely disappointed. My wife has had COVID last summer and is still dealing with neurological issues. She has been trying without success to get help from her PCP, and has made an appointment at a COVID Care Clinic, which has a five-month waiting list. She can’t get in until late August … which is more than a year after her initial infection.

    Can someone please recognize, publicize and take leadership on the post-COVID long-haul mental health issue?

  • Joanne O. says:

    I had covid last July and I am 57 yrs old I am I guess what you call a long hauler. I was in the hospital for 4 months and went home with oxygen. I am still on oxygen, I had double pneumonia but I’m a survivor. I never got on respirator and was awake through the ordeal. I have videos of what came out of my nose. When I couldn’t breathe. But I’m a survivor, I am from Florida.

  • Cheryl G. says:

    I am 61 years old. Had a positive test. I had a mild case, slept about 11 days straight. Aches in places that shouldnt ache. Not hungry for about 8 days. Forced myself to get up and around. 5 weeks out, terrible fatigue. Still problems with breathing. Hair loss unreal.

  • Delia L. says:

    I am 56 years old had Covid 19 hospitalized in December 2020 6 days. Also had pneumonia with glass like looking specs in lungs. Still have SOB, CXR shows clear, CT SCAN NEGATIVE, PFTS pulmonary function test good had sleep study results pending. Coronary Calcification test to be scheduled, and exercise stress test had a echo. I am very fatiqued, sleepy and loosing hair. I had my vaccines 1 and 2. I want to feel my self.

  • Kevin says:

    Had COVID 6 months ago. Have had abdominal pain and have lost over 70 pounds. Had all the tests and all organs working well. Pudding, jello, and Boost have been my diet. Any one else having theses issues?

    • Ashley H says:

      I did, Kevin. They started several months after I had mild covid. The abdominal pain was so terrible. I noticed some soothing relief from drinking pure aloe juice (the inner filet) that I found at my local Sprouts or Vons. It’s not a cure but it did provide some relief, and it can’t hurt.

      • Mark says:

        Any improvement for Kevin or Ashley? I have similar abdominal distress and also get a little relief from aloe. The pain is less constant/prolonged than it was a month or so ago (and for several months before that), but the severity is not much less.

  • Ashley H says:

    The number of individuals with lingering symptoms for substantial amounts of time will undoubtedly be much higher than we can imagine at the moment. Speaking from experience, I had a mild/semi-moderate case of COVID-19 in March of 2020 when I returned home from England. I never had a high fever (although I couldn’t find a thermometer anywhere online for weeks) or a dry cough, but the shortness of breath, fatigue, body aches, and just how I felt overall was like nothing I’d ever experienced in my 35 years on this planet. The virus went away and I started to feel pretty normal for about 2 months, and then in late July it was as though I was a cancer patient. My entire body was in so much pain. I constantly felt tingling and numbness throughout my feet and hands. At times I couldn’t walk it hurt so bad. The laundry list of symptoms that followed and have remained with me are incredible. I couldn’t eat and I lost nearly 20lbs from my previously healthy 110lb, 5’3″ petite frame. Thankfully, I work for a neurologist so I am aware of cognitive functions, impairments, defects, etc., but nothing will really prepare you for how to handle the feeling of not understanding how to put your clothes on in the morning, or basic normal daily work tasks.

    Unfortunately, finding anyone to treat me or enroll me in a study is nearly impossible. I’ve spent thousands on treatment just to be told nothing is wrong or that it may be a vitamin deficiency (side note: I now have developed a vitamin D deficiency as a result of Covid). I am not alone in my situation. Countless people I’ve spoken with all have had the same experience. And since I am a 35-year old, formerly healthy woman, I do not qualify for most studies or treatment. If anyone has any guidance or know of anyone I can contact, help would be greatly appreciated.

    I should note that I have found significant relief from the Moderna vaccine. I no longer feel the debilitating nauseousness and overwhelming fatigue that has kept me bedridden for several months. Although I still feel a slight queasiness from time to time, I am able to leave my house and attempt to exercise more frequently. My arm is ready for a 3rd dose if the mRNA vaccines continue to show signs of long-hauler improvement.

    ps…Yay Science! Thank you, Dr. Fauci!

  • Jake says:

    Can this effort please be expanded to those of us who are impacted by what’s called Chronic Fatigue Syndrome, Myalgic Encephalomyelitis, or Systemic Exertion Intolerance Disease for years or even decades? A lot of the symptoms overlap and finding a solution would be beneficial to society as a whole. We can likely provide valuable input on what does and does not work to manage your daily life to the Long Haulers as well.

  • Eric Smith says:

    Fifteen percent of healthcare workers at a Swedish hospital who recovered from mild COVID-19 at least 8 months before report at least one moderate to severe symptom disrupting their work, home, or social life.

  • Randy Jerome says:

    Very nice article! Social media really is a great way for seniors to keep up with what is going on with their children and grandchildren. Thanks for posting!

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