risk factors for prolonged Covid

Most of the people who attend the Covid-19 recover completely, although some suffer persistent symptoms associated with the disease time after having overcome the infection. We talk about what is known as “Prolonged Covid”​ and on which the health authorities have focused as it could become a serious public health problem in the medium and long term.

Despite the fact that Covid-19 is an eminently respiratory disease, scientific evidence has amply demonstrated in these more than two years of the pandemic that the coronavirus affects many organs and systems of our body. According to the conclusions drawn from various studies, the estimates that are used suggest that between 10 and 30% of people infected with SARS-CoV-2 they may develop long-term symptoms.

Some worrying data in an epidemiological scenario dominated by Omicron (B.1.1.529, originally detected in South Africa). In just a month and a half from the detection of the first cases, this variant managed to displace Delta (B.1.617, originally detected in India) as the dominant one at a global level thanks to its greater capacity for transmission and immune escape.

Fact that has been translated into Record numbers of infections never seen before throughout the pandemic Therefore, the aforementioned percentages related to the estimates of people affected by prolonged Covid are telling us about millions of people affected. And it is vitally important to highlight in this regard that prolonged Covid can occur regardless of the severity of the infection.

WHAT IS PROLONGED COVID?

On October 11, 2021, the World Health Organization (WHO) published the first official definition related to prolonged Covid. This was agreed after a global consultation with experts with the aim of facilitating its diagnosis and the treatment of affected people.

“The post-Covid-19 condition occurs in individuals with a history of confirmed or probable SARS-CoV-2 infection, usually three months after the appearance of Covid-19 with symptoms that last at least two months and that cannot be explained by an alternative diagnosis. The most common symptoms are fatiguethe difficulty breathing and cognitive dysfunction, but other symptoms can also occur that usually affect the daily functioning of the patient”, defines the WHO.

“Symptoms may be new onset, after initial recovery from an acute episode of Covid-19, or may persist from the onset of the disease. Symptoms may also fluctuate or relapse over time. For children, another definition may apply.”

“Post-Covid-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, generally three months after the onset of Covid-19 with symptoms lasting at least two months and not can be explained by an alternative diagnosis”

In relation to the last nuance on the definition in the case of childrenthe most widespread to date, was made public on February 10, 2022 by 120 international experts who have analyzed 49 definitions to reach a consensus:

• Condition in which a child/youth has symptoms (at least one of them must be physical) that have continued or developed after a positive diagnosis of Covid-19 with one or more positive tests.
• Your physical, mental, or social well-being is affected.
• They are interfering with some aspect of your daily life (for example, in school or your social relationships).
• Symptoms persist for a minimum of 12 weeks from the initial test confirming the case of Covid-19 (even if symptoms have increased or decreased during this period).

“The post-Covid condition occurs in young people with a history of confirmed SARS-CoV-2 infection, with at least one persistent physical symptom for a minimum of 12 weeks after initial testing. These symptoms cannot be explained by an alternative diagnosis and have an impact on the performance of your daily life. They can fluctuate or relapse over time”, the experts conclude.

RISK FACTORS FOR DEVELOPING PROLONGED COVID

Until now, the scientific evidence has not been able to clearly explain the reasons why some people develop these persistent symptoms and others do not. Recent research in this regard seems to suggest that there are some factors that could increase the risk of suffering persistent symptoms derived from Covid-19 after overcoming the infection.

In this sense, the focus is placed, for example, on high levels of viral RNA in the early stages of infection by SARS-CoV-2, the presence of certain autoantibodies mistakenly attack body tissues as occurs with autoimmune diseases), the reactivation of the Epstein-Barr virus (some studies they not only associate it with prolonged Covidbut also with the severity of the infection) and including the type 2 diabetes.

One study published in December 2021 in The Journal of Infectious Diseasespoint to the high levels of cytokines in infected people as the triggering mechanism for persistent symptoms within 90 days of onset of infection. Its authors have established a relationship between a persistent immune activation in response to SARS-CoV-2 as a possible origin of prolonged Covid.

Predicting the risk of prolonged Covid can be vital for certain vulnerable groups. In this sense a recent study published by British Medicine Journal focused on finding a immunoglobulin “signature” which could be used to predict which patients are the most likely to suffer from prolonged Covid.

Because health we all need… ConSalud.es

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