BIRMINGHAM, United Kingdom — Hair loss and a low sex drive are joining the growing list of lingering symptoms people are dealing with after a case of COVID-19 — a condition called long COVID.
The major British study involved more than two million people and adds these problems to a list that already includes brain fog and chronic fatigue. Now, researchers have discovered that long COVID sufferers have experienced a much wider set of over 60 symptoms — including sexual dysfunction and alopecia. Previous studies have found that list could actually be closer to 200 symptoms.
Their findings, published in the journal Nature Medicine, showed that patients with a confirmed record of coronavirus infection reported 62 symptoms much more frequently 12 weeks after their initial infection than those who did not contract COVID.
The team analyzed anonymized electronic health records of 2.4 million people in the U.K. during this study. The data, collected between January 2020 and April 2021, involved more than 480,000 people with prior infection and 1.9 million people with no indication of coronavirus infection after matching for other clinical diagnoses.
Incontinence and erectile dysfunction on the list too?
Using only non-hospitalized patients, the team identified three categories of distinct symptoms reported by people with persistent health problems after infection. These groups included respiratory symptoms, mental health and cognitive problems, and a broader range of COVID-related symptoms.
While the most common symptoms include losing the sense of smell, shortness of breath, chest pain, and fever, the team also discovered patients with amnesia, bowel incontinence, erectile dysfunction, hallucinations, limb swelling, and apraxia – the inability to perform familiar movements or commands.
“This research validates what patients have been telling clinicians and policy makers throughout the pandemic, that the symptoms of long COVID are extremely broad and cannot be fully accounted for by other factors such as lifestyle risk factors or chronic health conditions,” says study senior author Dr. Shamil Haroon, Associate Clinical Professor in Public Health at the University of Birmingham, in a media release.
“The symptoms we identified should help clinicians and clinical guideline developers to improve the assessment of patients with long-term effects from COVID-19, and to subsequently consider how this symptom burden can be best managed.”
“This study is instrumental in creating and adding further value to understanding the complexity and pathology of long COVID. It highlights the degree and diversity of expression of symptoms between different clusters. Patients with pre-existing health conditions will also welcome the additional analysis on risk factors,” adds study co-author Jennifer Camaradou.
Who is most at risk for long COVID?
Along with discovering a wider range of long COVID symptoms, the research team also found key factors and behaviors which put people at an increased risk of developing the condition. The study suggests that women, younger people, Blacks, and mixed or other ethnic groups are at a greater risk of developing long COVID.
People from less affluent socio-economic backgrounds, smokers, those who are overweight or obese, and those with pre-existing health conditions were also more likely to report lingering COVID-related symptoms after their illness.
“Our data analyses of risk factors are of particular interest because it helps us to consider what could potentially be causing or contributing to long COVID. We already know that certain modifiable traits such as smoking and obesity put people at increased risk of various diseases and conditions, including long COVID. However, others such as biological sex and ethnicity also appear to be important,” reports study lead author Anuradhaa Subramanian, a research fellow at the University of Birmingham.
“Women are for example more likely to experience autoimmune diseases. Seeing the increased likelihood of women having long COVID in our study increases our interest in investigating whether autoimmunity or other causes may explain the increased risk in women. These observations will help to further narrow the focus on factors to investigate that may be causing these persistent symptoms after an infection, and how we can help patients who are experiencing them.”
This study focused on the first phase of the pandemic in the U.K. between January 2020 and April 2021. Researchers say the data provided them with an opportunity to compare meaningful numbers of people who had coronavirus to a control group of uninfected people. The research team included epidemiologists, clinicians, data scientists, statisticians, and patients from across Britain, who decoded electronic health records to accurately capture the full picture of long COVID.
“The results are both a testament to the opportunities that these public health datasets provide, and to the power of collaborative work to provide much needed evidence around the experiences of many people who have been affected by persistent symptoms after infection with the coronavirus,” Dr. Haroon concludes.
“I hope our research will also further validate the voices of patients and involvement groups and provide an approach to support healthcare responses to new and emerging diseases.”
South West News Service writer Stephen Beech contributed to this report.
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