A new study from researchers at Mount Sinai shows just how serious long COVID can be, and how long it can last — even for patients who weren’t hospitalized.
The study, published Monday in the “American Journal of Physical and Rehabilitation Medicine,” looked at 156 patients who were treated at Mount Sinai’s Center for Post-COVID Care between March 2020 and March 2021. Researchers found that 63% of patients were experiencing at least mild cognitive dysfunction, and that long COVID can impact physical and cognitive function, quality of life and employment for at least one year.
“The main takeaway here is to understand how complex and multifactorial long COVID is. It’s also important to take away just how much it affects every single aspect of a person’s daily life and daily functioning,” Dr. David Putrino, lead author of the study and director of Rehabilitation Innovation for the Mount Sinai Health System, told MarketWatch.
Post-acute COVID-19 Syndrome (PACS), commonly called “long COVID,” is characterized by persistent and debilitating symptoms that are still present at least four weeks after initial infection.
For the study, patients were asked to fill out a survey that had detailed questions about possible long COVID symptoms, including fatigue, breathlessness, ability to complete moderate and vigorous physical activity, cognitive function, health-related quality of life, anxiety, depression, disability and their pre- and post-COVID-19 employment status.
Eighty-two percent of respondents reported fatigue, while 67% reported brain fog, 60% reported headaches, 59% reported sleep disturbance and 54% reported dizziness.
Researchers then performed a more in-depth evaluation for self-reported cognitive impairment, finding that 63% of patients had some level of cognitive dysfunction, including diminished short-term memory, difficulty remembering names and issues with decision-making and daily planning.
Of the 102 respondents who reported full employment pre-COVID-19 infection, only 55 said they had full-time work post-infection.
“It is clear that in the wake of the COVID-19 pandemic, a second, longer term public health emergency has emerged,” the researchers wrote.
Importantly, Putrino said, this study included patients who didn’t have a positive PCR or antibody test, “because testing for COVID is often unreliable.” Studies have shown PCR tests report false negatives 20% of the time and that 36% of those who had COVID-19 don’t develop antibodies.
Researchers followed World Health Organization and Centers for Disease Control and Prevention diagnostic guidelines to identify patients who had an infection resulting in long COVID but didn’t have a positive PCR or antibody test.
“Physicians need to understand that even if a patient comes to them and they have a negative PCR, or they have no PCR because they couldn’t access testing at the time that they got unwell, or they don’t have antibodies — that doesn’t mean they didn’t have COVID,” he said.
Not counting those patients is “bad from a health equity standpoint, because there are a lot of people who are part of historically excluded groups that often get access to worse health care and worse access to testing,” he said.
As for severity of infection leading to long COVID, the vast majority of patients in this study weren’t hospitalized, Putrino said, and most of them reported having a less severe COVID-19 infection.
“What this tells us is that even if you don’t get hospitalized, even if you don’t feel like your initial acute infection with COVID was significant, there can still be symptoms that persist for months, and in fact years after your initial acute infection,” he said.
What researchers are so far seeing, Putrino told MarketWatch, is that if you were hospitalized with COVID-19, there’s a 50% chance you will have long COVID symptoms. And even if you weren’t hospitalized, there’s still a 10% to 20% chance of developing persistent COVID symptoms, he said.
“People need to keep hearing that the odds aren’t really in your favor of not getting long COVID,” Putrino said. “So we need to be really careful about reducing the number of infections that are currently occurring, because, right now, we have a lot of daily infections.”
There are currently an average of more than 75,000 new COVID-19 cases each day, and the U.S. so far has a total 45.4 million COVID-19 cases and 735,941 deaths.