Long Haulers: 1 in 10 Healthcare Workers have COVID-19 Symptoms 8 Months Later

A new study reveals that 1 in 10 healthcare workers who had mild COVID-19 were still coping with at least one moderate to severe symptom eight months later.

COVID-19 “long haulers” or “long haul syndrome” occurs for people who have not fully recovered from the virus weeks or months after first experiencing symptoms — also termed post-COVID-19 syndrome or post-acute sequelae of SARS-CoV-2 infection (PASC). Some long haulers experience continuous symptoms for 28 days to several months post infection. Other long haulers may feel better for a time, but then experience a relapse with one or more of the following symptoms occurring:

• Loss of taste or smell
• Fatigue
• Headaches
• Confusion, memory loss or brain fog
• Body aches or joint pain
• Chest pain
• Persistent cough
• Shortness of breath

1 in 3 COVID-19 Survivors Suffers a Neurological or Psychiatric Disorder

A study led by researchers at the University of Oxford and published in the Lancet Psychology Journal revealed that one in three COVID-19 survivors has suffered a neurological or psychiatric disorder within six months of infection with the virus.

The results were based on analyzed data from the electronic records of 236,379 COVID-19 patients. Overall, the estimated incidence of being diagnosed with a neurological or mental health disorder following COVID-19 infection was 34%. For 13% of these people, it was their first recorded neurological or psychiatric diagnosis. The most common diagnoses included:

• Anxiety (17%)
• Mood disorders (14%)
• Substance misuse disorder (7%)
• Insomnia (5%)

The incidence of neurological outcomes was lower, including 0.6% for brain hemorrhage, 2.1% for ischemic stroke, and 0.7% for dementia.

After taking into account underlying health characteristics such as age, sex, ethnicity, and existing health conditions, there was overall a 44% greater risk of neurological and mental health diagnoses after COVID-19 than after flu, and a 16% greater risk after COVID-19 than with respiratory tract infections.

Inability to Return to Work Post COVID-19

Another study published as a pre-print on medRxiv surveyed 3,762 respondents who were self-reported “long haulers” from 56 different countries. 96% reported symptomatology beyond 90 days. The most frequent symptoms reported after six months were fatigue, post-exertional malaise, and cognitive dysfunction that impacted day-to-day activities and return to work.

The majority of respondents (88%) said they coped with some form of cognitive dysfunction or memory loss that affected their everyday lives such as decision-making abilities, following instructions, or driving. Most also reported they experienced a relapse of symptoms triggered by exercise, mental activity, or stress.

Many of the long haulers reported prolonged multisystem involvement and significant disability. In fact, of those who had prolonged symptoms for more than six months, they experienced about 14 different symptoms on average. Many patients were not recovered by seven months and continued to experience significant symptom burden.

1 in 10 Healthcare Workers is a Long Hauler

A study published in April 2021 in JAMA examined relatively young, healthy adult healthcare workers in Sweden. The results indicated that approximately one 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.

Overall, 11% of the healthcare workers with mild COVID-19 reported long-term symptoms, and these symptoms disrupted work, social, and home life. The most common symptoms lasting for at least two months were loss of taste or smell, fatigue, and dyspnea.

Can we predict who becomes a long hauler?

One study did indicate that patients who experienced more than five symptoms during their first week of COVID-19 illness were more likely to become long haulers. Also, those with increased age and higher body mass index had an increased likelihood of long-term symptoms.

However, until we have more information, the truth is that anyone can become a long hauler. Clearly, the study reported in JAMA showed that one out of 10 low-risk individuals (young, healthy adults) also became long haulers. Ultimately, further research will be needed to predict who may become a long hauler. There simply are no definite answers at this time about what causes ongoing symptoms.

In February 2021, the National Institutes of Health announced a $1.15 billion initiative to support research into the causes and ultimately the prevention and treatment of long-haul COVID. You can read more about this initiative here.

References:

1. The Lancet Psychiatry. 2021 April;8(5):416-427.
2. https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v2.full.pdf
3. JAMA. 2021 April.
4. National Institutes of Health: Trying to Make Sense of Long COVID Syndrome retrieved April 26, 2021.
5. Harvard Health Publishing/Harvard Medical School: If You’ve Been Exposed to the Coronavirus retrieved April 26, 2021.