Long symptoms of COVID may include hair loss, difficulty ejaculating

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Symptoms of long COVID can vary from individual to individual. 10,000 hours/Getty Images
  • Researchers analyzed primary care data from the UK to identify symptoms and risk factors for long COVID.
  • They found 62 symptoms of long COVID, including hair loss and reduced libido, as well as several risk factors such as smoking or being socially disadvantaged.
  • They concluded that SARS-CoV-2 infection is linked to various symptoms associated with sociodemographic and clinical risk factors.

After contracting SARS-CoV-2, approximately ten% of people develop long COVID, or persistent and recurrent symptoms 4 to 12 weeks after infection. These symptoms usually last for at least two months and cannot be explained by other diagnoses.

Systematic Comments showed that the most common symptoms include:

  • fatigue
  • shortness of breath
  • muscle pain
  • articular pain
  • headache
  • cough
  • chest pain
  • altered odor
  • altered taste
  • diarrhea

As many of these studies were based on self-reported symptoms or lacked a control group, inferences drawn from them about long COVID symptoms may be limited.

Recently, researchers conducted a large-scale analysis of UK primary care data to investigate a full range of long-lasting COVID symptoms.

They identified 62 symptoms as being significantly associated with a history of SARS-CoV-2.

The study was published in natural medicine.

For the study, researchers looked at primary care data collected between January 31, 2020 and April 15, 2021 from 486,149 adults with a confirmed diagnosis of COVID-19 and 1,944,580 controls with no history of COVID-19 infection. SARS-CoV-2.

Participants were matched on sociodemographic characteristics, including smoking status, body mass index (BMI), and comorbidities at baseline.

Their average age was 43.8 years and 55.3% were women. A total of 64.7% of participants were white, 12.2% were Asian, 4% were black Afro-Caribbean, and 16.2% lacked ethnicity data.

After adjusting for demographic factors, the researchers found that 62 symptoms were linked to a history of SARS-CoV-2 infection.

The most common symptoms, including new additions, were:

  • anosmia (loss of sense of smell)
  • hair loss
  • sneeze
  • ejaculation difficulty
  • reduced libido
  • shortness of breath at rest
  • fatigue
  • pleuritic chest pain
  • hoarsely
  • fever

The researchers were further able to group these symptoms into three main groups:

  • A wide range of symptoms including pain, fatigue and rashes – 80%
  • Respiratory symptoms, including cough, shortness of breath and phlegm — 5.8%
  • Mental health and cognitive symptoms including anxiety, depression, insomnia and brain fog – 14.2%

They also found that long COVID symptoms were more pronounced in the second wave than in the first wave.

While the diagnosis of COVID-19 was linked to a 28% relative increase in reporting cough after 12 weeks during the first wave, it was linked to a 77% relative increase during the second wave.

The researchers also conducted a risk factor analysis for long COVID involving 384,137 people who contracted SARS-CoV-2. Overall, they found that women were at increased risk than men for long COVID.

Meanwhile, people aged 30-39 and over 70 were 6% and 25% less likely than 18-30 year olds to develop long COVID.

They further found that people of black Afro-Caribbean, mixed ethnicity, Native American, Middle Eastern or Polynesian descent were more likely to develop long COVID than white ethnic groups.

Social deprivation also played a role; those with the highest levels of socioeconomic deprivation were 11% more likely to develop long COVID than the less deprived.

Other risk factors included:

  • be a smoker or former smoker
  • being overweight or obese
  • comorbidities such as chronic obstructive pulmonary disease (COPD), fibromyalgia and depression.

When asked what might underlie the long list of COVID symptoms, Dr. Shamil Haroona clinical lecturer at the University of Birmingham’s Institute of Applied Health Research, one of the study’s authors, said Medical News Today:

“The mechanisms that cause long COVID are not well understood, and the list of hypotheses is quite diverse, including organ damage (eg, lung scarring) from acute infection, chronic inflammation, viral persistence , endothelial dysfunction and blood clots, autoimmunity, mast cell activation, and many more.

“Long COVID is unlikely to be a single condition, but rather several overlapping conditions that occur after SARS CoV-2 infection.”
— Dr. Shamil Haroon

Dr. PJ Utzprofessor of immunology and rheumatology at Stanford University, who was not involved in the study, said DTM:

“Almost certainly, multiple mechanisms underlie the long COVID and partly explain the incredible heterogeneity. For example, intense inflammation during initial illness can damage tissue, leading to long-term signs and symptoms. This may underlie some findings such as anosmia and pulmonary symptoms.

“Endothelial dysfunction and microcoagulation [have] been observed in acute illnesses. Activation of the immune system leading to inflammation and development of autoantibodies is also likely to be important. The large NIH RECOVER study is actively pursuing all of these mechanisms,” he noted.

The researchers concluded that SARS-CoV-2 is linked to various symptoms related to sociodemographic and clinical risk factors.

Asked about the limitations of the research, Dr Haroon said more data was needed to get the full picture.

“The limitations of our research include the fact that we only considered symptoms that were reported to primary care services. We therefore cannot comment on the overall prevalence of these symptoms in the general population, as many people who have had Covid for a long time do not necessarily report their symptoms to their GP,” he said.

“We also used coded data from health records. Many symptoms will be recorded by clinicians as free text, which we did not have access to analyze,” he added.

Dr Utz agreed with Dr Haroon and suggested that this research opens avenues for future research.

“A very important question that has not yet been addressed is whether an increase in incident classifiable autoimmune diseases is observed – if so, this would suggest that severe acute viral infection can directly trigger auto -immunity,” he said.

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