Covid-19 cases and deaths have decreased globally, yet, the long term consequences of infection, including post-covid-19 condition (often known as long covid), are still being managed. Most people who have covid-19 recover soon after the acute phase of the disease but others experience persistent health problems for months or longer, and these problems can impact quality of life and ability to work. Understanding the trajectory of symptom burden and recovery from post-covid-19 condition is crucial for policy making, treatment decisions, and care coordination.
Early studies reported widely varying estimates of post-covid-19 condition prevalence and symptom trajectories, mainly due to differences in sample representativeness and survey designs. As commented on by previous work, research has been limited by: data sources not representative of the general infected population because much covid data are based on patients admitted to hospital; scarcity of information on symptom trajectory because population level studies rarely survey a comprehensive set of symptoms or the change in their severity; absence of a comparable covid-free control group because some symptoms might result from existing conditions or seasonal illness; and recall bias because the experience that respondents are asked to recollect can easily date back to months, or even years, ago.
The linked article in The BMJ by Tala Ballouz and colleagues (doi:10.1136/bmj-2022-074425) makes an important contribution to the study of post-covid-19 condition by addressing many of these limitations. The analyses are based on a population based, prospective, longitudinal cohort of unvaccinated individuals who contracted a SARS-CoV-2 infection between 6 August 2020 and 19 January 2021 and who were compared with individuals who had not had the virus, all from canton of Zurich, Switzerland. The survey collected information on 23 potential symptoms of post-covid-19 condition, their severity, and their perceived relevance to covid-19, which were assessed over 24 months. For symptoms that were hard to measure, such as fatigue, dyspnea, depression, and stress, a scale based assessment was adopted.
Ballouz and colleagues found that recovery after infection did not occur in 23% of individuals at six months, in 19% at 12 months, and in 17% at 24 months.The proportions of people still experiencing symptoms perceived to be related to covid-19 at the three timepoints were similar but slightly higher, decreasing from 29% at six months, to 20% at 12 months, and to 18% at 24 months. These findings are consistent with previous studies with similar time frames, and extend our knowledge of post-covid-19 condition to two years after infection. Importantly, compared with people who did not have an infection, those with covid-19 had excess risks for both physical problems (eg, altered taste or smell, malaise after exertion, fatigue, and dyspnea) and mental health issues (eg, reduced concentration and anxiety) at month six.
Most patients with persistent covid symptoms after infection recovered between six months and 12 months, but those who did not recover seemed to develop chronic health problems and had very little improvement after month 12. People who were symptomatic at all follow-ups or reported worsened symptoms were more likely to be older and to have pre-existing health problems.
This new study identifies remaining uncertainties and indicates where future research is needed. Post-covid-19 condition may induce a wide variety of symptoms, each with independent courses and complex inter-relationships. The study did not aim to evaluate all possible symptoms but surveying for more in future studies might show a more complete picture of the experience of post-covid-19 condition. Another recent The BMJ article3 provides a good example. The authors examined 30 postacute covid symptoms and identified 13 combinations of symptom clusters, including patterns of cluster co-occurrence. The most prevalent symptom cluster observed was fatigue, which frequently co-occurred with neurocognitive impairment and chest symptoms.
An important limitation of Ballouz and colleagues’ study was its focus on only wild type SARS-CoV-2 in an unvaccinated population. Empirical evidence accounting for vaccination status and later virus strains is emerging. For example, another study found that vaccinated individuals with breakthrough infections had a significantly lower risk of persistent dyspnea and hair loss 30-90 days after infection when compared with unvaccinated individuals. Additionally, the risks of developing post-covid-19 condition were not significantly different among people who had an infection with wild type, alpha, or delta variants.
Post-covid-19 condition remains a global public health crisis. The design of future treatments, clinical trials, and policy interventions will depend on robust studies based on high quality population level data. Further studies focusing on more recent phases of the pandemic, and accounting for complexities (eg, more virus strains, vaccination statuses, and reinfections), will be particularly valuable. Additionally, in view of the complexity of symptom trajectories and the unique disease burden experienced by each individual patient with post-covid-19 condition, patients should be more closely involved in the design and conduct of these studies going forward.
. . . the (German) Federal Ministry of Education and Research . . .
You said that someone in Germany was in possession of the virus in April of that same year. Now, from whom or where did they receive the virus?
Here in Germany researchers at the Institute of Virology at the University Hospital Düsseldorf successfully isolated the SARS coronavirus type 2 from patient swabs as early as 25 March 2020.
Now, from whom or where did they receive the virus?
Quote:. . . the (German) Federal Ministry of Education and Research . . .
In October of 2020, a Dr Thushan de Silva, from the University of Sheffield’s Department of Infection, Immunity and Cardiovascular Disease is quoted as saying:
“There are now hundreds of stocks of cultured SARS-CoV-2 in laboratories around the world.”
So far, that has turned out to be a lie. There is a list of well over a hundred medical institutions, organizations, offices, and individuals who've admitted to not being in possession of the virus, but only after they were forced to respond to a submitted FOIA request. The list continues to grow.
Are you really suggesting that institutions outside the USA are obliged to respond your FOIA requests?
As early as February 2020, the "SARS-CoV-2 was isolated for the first time using epithelial cells of the human respiratory tract and classified into the subgenus Sarbecovirus of the Beta-CoVs by phylogenetic analyses of the gene sequences by Korean scientists.
Shortly afterwards, research institutions in the USA and Canada followed suit.
I didn't tell you that, neither unwittingly or in another way.
Explain why the FDA recommended a cycle-threshold that fauci has clearly stated is inappropriate.
Explain why the FDA recommended a cycle-threshold that fauci has clearly stated is inappropriate.
This has been an idée fixe of yours for several years now
Why does Fauci have to be perfectly infallible while your leader is full of ****?
Are Covid-19 vaccine cards still relevant?
Here’s what experts say...
When was the last time you needed to use your Covid-19 vaccine card?
Chances are you can’t remember.
During the height of the pandemic, it was the key to entering some concert venues, traveling to certain countries and more. Now, the once critical document has all but been forgotten.
As people have adjusted to post-pandemic living, are these small white cards still relevant? Experts share when you do — and don’t — need your card, plus how to replace it in case it’s gone missing.
Treat your vaccine card as a medical record
Your Covid-19 vaccine card should be included as part of your medical record, similar to your personal vaccination record, said Kathleen Conley, spokesperson for the US Centers for Disease Control and Prevention. That way, the card can be used as proof of vaccination when you and your health care provider make future medical decisions, she said.
In addition to providing a copy to your primary care provider, it’s recommended to keep a personal record of it as well.
“Your provider might keep these records for a period of time, however, it is a good practice to keep copies of your records just in case you need them later on,” Conley said via email.
You probably don’t need your card to travel
The federal government no longer requires people to show their vaccine card when traveling to the United States from outside the country, said Tori Emerson Barnes, executive vice president, public affairs and policy, at the U.S. Travel Association.
She added that the association is not aware of any vaccination requirements to travel within the US.
Most countries have also stopped requiring proof of vaccination to enter, but you should still check with your specific destination before leaving the US, Conley said.
How to replace your Covid-19 vaccine card
Don’t fret if you’ve misplaced your pocket-size document. There are several ways to replace it.
First, contact your vaccination provider to request a copy of your vaccine record, Conley said.
If that is not possible, get in contact with your state health department’s immunization program, she said. “Vaccination providers must report COVID-19 vaccinations to their state immunization information system (IIS) and related systems,” Conley said in an email.
While the IIS won’t be able to supply you with a new card, the group can give you a copy of your vaccination record, she said.
If you bring your vaccination record to your doctor’s office, staff there might be able to provide a new card.
Do not contact the CDC
It might sound logical to call the US Centers for Disease Control and Prevention to get your card replaced. After all, its logo is on the card.
However, the agency did not give you the card. The organization provides the cards to vaccine providers, who then provide it to you. This also means the CDC does not keep track of vaccine records, so reaching out to your state’s IIS is your best bet.