Coronavirus particles, illustration - SARS-CoV-2 virus

It is time to stop using terms such as “long COVID” an Australian research team says. Such phrases, they say, imply there is something unique about longer term symptoms associated with COVID. But long COVID, this team maintains, is just a typical post-viral syndrome, indistinguishable from what is seen with seasonal influenza and other respiratory illnesses. 

Their study looked at symptoms in several thousand people with respiratory infections in the Australian state of Queensland. The team are presenting their findings at this year’s European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2024) in Barcelona, Spain (27–30 April), but shared details in a special early release.

They found that, in the highly vaccinated population of Queensland, long COVID’s impact on the health system probably stems from the sheer number of people infected with SARS-CoV-2 within a short period of time, rather than the severity of long COVID symptoms or functional impairment.

This work adds to previous research by the same authors and published in BMJ Public Health (August 2023). That report found no difference in ongoing symptoms and functional impairment when COVID-19 was compared with influenza, 12 weeks post infection.

Long COVID in Australia is relatively rare, due to high vaccination rates and the emergence of the Omicron variant, which tends to cause less serious disease. Symptoms reported with the illness include fatigue, brain fog, cough, shortness of breath, change to smell and taste, dizziness, and rapid or irregular heartbeat.

These researchers surveyed 5,112 symptomatic individuals aged 18 years and older, comprising those with PCR-confirmed infection for COVID-19 (2,399 adults) and those who were PCR negative for COVID-19 (2,713 adults: 995 influenza positive and 1,718 PCR negative for both but symptomatic with a respiratory illness) in 2022.

Laboratory reporting for COVID-19 and influenza is mandated upon PCR test request under Queensland’s public health legislation. A year after their PCR test, in 2023, participants were asked about ongoing symptoms and their degree of functional impairment using a questionnaire. 

Overall, 16% (834/5,112) of all respondents reported ongoing symptoms a year later, and 3.6% (184) reported moderate-to-severe functional impairment in their activities of daily life.

After controlling for influential factors including age, sex, and First Nation status, the analysis found no evidence that COVID-19 positive adults were more likely to have moderate-to-severe functional limitations a year after their diagnosis than symptomatic adults who were negative for COVID-19 (3.0% vs 4.1%).

Moreover, results were similar when compared with the 995 symptomatic adults surveyed who had influenza (3.0% vs 3.4%).

Interestingly, the analysis also found that people aged 50 years or older were more likely to report moderate-to-severe functional impairment as well as patients who had reported symptoms of dizziness, muscle pain, shortness of breath, post-exertional malaise, and fatigue.

“In health systems with highly vaccinated populations, long COVID may have appeared to be a distinct and severe illness because of high volumes of COVID-19 cases during the pandemic. However, we found that the rates of ongoing symptoms and functional impairment are indistinguishable from other post-viral illnesses,” said John Gerrard, Queensland’s chief health officer. “These findings underscore the importance of comparing post-COVID-19 outcomes with those following other respiratory infections, and of further research into post-viral syndromes.”

He adds, “Furthermore, we believe it is time to stop using terms like ‘long COVID’. They wrongly imply there is something unique and exceptional about longer term symptoms associated with this virus. This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery.”

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