Prevalence, risk factors and characterisation of individuals with long COVID using Electronic Health Records in over 1.5 million COVID cases in England

Follow-up of long COVID based on the definition of WHO: a multi-centre cross-sectional questionnaire-based study

BACKGROUND

Since long COVID has hindered people from normal life, it is essential to understand its full spectrum of manifestation. However, it was heterogeneous in the existing studies and few large-scale studies have been conducted on Asian populations. Here, we conducted a multi-centre questionnaire-based study among Chinese people to explore the long COVID based on the definition of WHO.

METHODS

During March 20, 2023 and June 18, 2023, individuals with a history of confirmed or self-reported SARS-CoV-2 infection were recruited from three hospitals to fill out the questionnaire for long COVID. Each symptom was assigned with 0 to 3 points based on their severity. And the long COVID score was a sum of these points of each symptom. The reporting rate, time trend and risk factors of long COVID stratified by different systems were explored.

RESULTS

3,693 individuals were recruited for the study. The reporting rate of at least one persistent long COVID symptoms and symptoms impacting daily life was 30.2% (1,117) and 10.7% (394). Systemic symptoms (20.7%, 765) were most easily reported. The most common symptoms were fatigue (16.3%, 602), cough (6.3%, 234) and expectoration (5.5%, 203). The reporting rate of long COVID and long COVID score decreased over time during a 180-day follow-up period (P < 0.05). For long COVID, older age (OR: 1.63, 1.38-1.93), female (OR: 1.19, 1.03-1.38) and SARS-CoV-2 reinfection (OR: 3.56, 2.63-4.80) were risk factors; while number of COVID-19 vaccine doses (OR: 0.87, 0.81-0.94) was a protective factor. The use of traditional Chinese medicine (OR: 0.51, 0.37-0.71) was a protective factor for symptoms impacting daily life.

CONCLUSIONS

Early interventions should be taken to minimize the impact of long COVID, especially for the elderly, females and those with SARS-CoV-2 reinfection. COVID-19 booster vaccination might play a potential role in minimizing the impact of long COVID.

Post-acute sequelae of COVID-19 in people of Black ethnicities living with HIV in the United Kingdom

BackgroundThe COVID-19 pandemic disproportionately affected people of Black ethnicities, however, there are limited data on the post-acute sequelae of COVID-19 infection in these populations, and none in those with HIV.MethodsWe conducted a cross-sectional study in people of Black ethnicities with HIV in the UK. Participants were assessed for functional impairment, frailty, respiratory symptoms, anxiety and depression; they were also asked to rate aspects of their physical and mental health on a scale from 1 (poor) to 10 (excellent), both at enrolment and prior to the pandemic. We report associations with COVID-19 history and recovery status.ResultsWe enrolled 183 participants between June 2021 and October 2022, 131 (72%) of whom reported COVID-19. A history of COVID-19 was associated with a reduced ability to carry out usual activities (OR 2.54 [1.03-6.21], p = 0.04), an increase in pain, tiredness and breathlessness, and overall decline in physical health. Of those with a history of COVID-19, 111 (85%) reported to have fully recovered. Those who had not fully recovered reported poorer functional status (p < 0.001) and had higher generalised anxiety scores (p = 0.02). Objective measures of physical function were similar in those who reported no COVID-19, COVID-19 with full recovery, and COVID-19 with incomplete recovery.ConclusionsIn this cohort of Black people with HIV, participants with a history of COVID-19 reported a reduced ability to carry out activities of daily living and various other health issues. Although most people reported full recovery from COVID-19, self-reported limitations in functional status and anxiety were common sequelae.

Medical ambivalence and Long Covid: The disconnects, entanglements, and productivities shaping ethnic minority experiences in the UK

Structural violence - related to 'isms' like racism, sexism, and ableism - pertains to the ways in which social institutions harm certain groups. Such violence is critical to institutional indifference to the plight of ethnic minority people living with long-term health conditions. With only emergent literature on the lived experiences of ethnic minorities with Long Covid, we sought to investigate experiences around the interplay of illness and structural vulnerabilities. Thirty-one semi-structured interviews with a range of UK-based participants of varying ethnic minorities, ages and socio-economic situations were undertaken online between June 2022 and June 2023. A constant comparison analysis was used to develop three over-arching themes: (1) Long Covid and social recognition; (2) The violence of medical ambivalence; and (3) Pathways to recognition and support. Findings showed that while professional recognition and support were possible, participants generally faced the spectre and deployment of a particular mode of structural violence, namely 'medical ambivalence'. The contours of medical ambivalence in the National Health Service (NHS) as an institution had consequences, including inducing or accentuating suffering via practices of care denial. Despite multiple structurally shaped ordeals (like healthcare, community stigma, and sexism), many participants were nevertheless able to gain recognition for their condition (e.g. online, religious communities). Participants with more resources were in the best position to 'cobble together' their own approaches to care and support, despite structural headwinds.