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Symptoms of long COVID improve in half of patients within three years of the infection that triggered their illness.
That’s the main finding of a new study that followed more than 1,000 patients with long COVID, a chronic illness that can appear after infection with the SARS-CoV-2 virus. Among patients, the chances of improvement varied widely depending on how the disease affected their body systems.
In the study, published Tuesday November 3 in the journal Internal annals MedicineAbout 60% of patients whose predominant symptoms were changes in their ability to taste or smell improved significantly three years after their first positive test. But less than 20% of those with multisystem presentation improved during this period.
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The latter group presented symptoms affecting, among other things, their cardiac, nervous and gastrointestinal systems. One expert told Live Science that the disease resembles myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which often occurs after an infection and similarly affects a wide range of body systems.
The new study’s findings could help guide the structure of future clinical trials of long-COVID treatments, experts said.
One disease, several symptoms
Study patients were recruited long-term RECOVER study for adults. Funded by the National Institutes of Health, the project recruited thousands of adults across the United States who had previously tested positive for COVID-19.
Researchers assessed patients based on how they were affected by a range of symptoms, including fatigue, brain fog, shortness of breath and heart palpitations. The study included patients who scored more than 10 points on a 30-point scale – called the 2024 LC Research Index (LCRI) – that attempted to capture these different combinations of symptoms.
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Nearly 1,020 patients met this requirement and were followed over time; they had in-person appointments and completed symptom surveys every three months. Scientists marked patients as “improved” after recording LCRI scores of 10 or less on two consecutive visits. They found that 36% of participants had improved two years after their COVID-19 infection, and this increased to 50% after three years.
LCRIs reached zero for 26% of participants after three years, meaning all of their symptoms were gone by the time of the survey.
Reeder said he was careful to avoid describing the participants as “cured.” This decision was influenced by the long COVID community’s input into the RECOVER study in adults, he said. They emphasized that their symptoms may wax and wane, while “recovery” implies permanent resolution. The new study did not, for example, know whether individual patients who experienced significant improvement subsequently relapsed.
Researchers analyzed which strain of SARS-CoV-2 was associated with the longest COVID cases, controlling for patients’ vaccination status.
(Image credit: koto_feja via Getty Images)
The journey for some patients has been much less straightforward than the baseline data might suggest. Although men and women improved at similar rates, adults younger than 46 were more likely to improve than older participants. Patients affected by Omicron variants Cases of SARS-CoV-2, which emerged in 2021 and quickly became the dominant strain of the virus, were more likely to improve than those infected with earlier strains.
ME/CFS and long COVID
Some of the starkest differences in improvement rates were seen between patients with different symptoms.
In a previous studyRECOVER researchers grouped participants into five subtypes, using an algorithm to link patients with similar predominant symptoms:
- Loss of smell or taste
- Chronic cough
- Brain fog
- Heart palpitations
- Symptoms affecting multiple body systems
In the new study, patients in the latter three groups were less likely to improve within three years. The rate for the latter group was particularly low, at just 19%.
Dr. Carmen Scheibenbogenimmunologist at the Charité Medical University in Berlin, said these patients’ progress resembles that of people with ME/CFS.
“It appears that at least one major subgroup has ME-CFS,” Scheibenbogen said, noting that COVID-19 may have triggered their illness. “It is a disease triggered by different infections, but ultimately the disease (itself) is very similar,” she said.
Like Long COVID, ME/CFS can affect a wide range of body systems. remains poorly understood despite recent research advances.
The team’s new findings highlight the need for clinical trials to test possible treatments for long COVID. Scheibenbogen and study co-author Harrison Reederbiostatistician at Massachusetts General Hospital, said these subtypes would be important to consider in the design of these potential trials.
The multisystem subgroup, Reeder said, “might be a group in which effective intervention can make a bigger difference than people who potentially have a greater chance of improvement anyway.”
Future work will need to deepen scientists’ understanding of people affected by long COVID at the level of their genes and proteins, the two scientists said.
“There is a lot of work to be done in RECOVER and in the world of long COVID research,” Harrison said. “There are a lot of opportunities.”
This article is for informational purposes only and is not intended to offer medical advice.
Gn Health
