ComPaRe Covid long follows the evolution of symptoms over 1 year

Paris, France – About 10% of people infected with SARS-CoV-2 have symptoms that last over time. How does the Covid evolve over time? Which symptoms disappear or lessen? On the contrary, are there any that appear? By analyzing data from 968 patients from the long ComPaRe Covid cohort French researchers from the University of Paris Cité / Assistance Publique – Hôpitaux de Paris (AP-HP) have just described in detail the dynamics of the symptoms of long Covid in Nature communication [1]. This is the first prospective observational study on the subject. We learn that 12 months after the onset of symptoms, 84.9% of patients who had persistent symptoms still report symptoms of long Covid. The authors also describe that the disease evolves over time with, for example, the appearance of new symptoms. The description of individual trajectories, the identification of patient profiles associated with such and such symptoms or even the observation of changes in trajectories thanks to specific care (physiotherapist, nutrition, rehabilitation, etc.) of long Covid are not however not documented here.

12 months after the onset of symptoms, 84.9% of patients who had persistent symptoms are still reporting symptoms of long Covid.

A cohort of patients with a long Covid

ComPaRe Covid long is a cohort of the major public research project ComPaRe which started in 2017 and whose objective is to better understand chronic diseases. Participants answer online questionnaires about their health, illnesses and symptoms.

In addition to a general cohort, there are fourteen other cohorts dedicated to different pathologies: diabetes, Verneuil’s disease, vitiligo, chronic low back pain, kidney disease, vasculitis, arterial hypertension, endometriosis, neurofibromatosis and Marfan syndrome.

The ComPaRe Covid long cohort began in 2020 and recruitment is still ongoing, the authors recall. Of the 1859 patients in this cohort as of October 15, 2021, data from 968 patients were analyzed. These patients had a PCR confirming infection with SARS-Cov2 or serology, persistent symptoms for at least two months and their date of inclusion in the cohort allowed a follow-up of at least two months. They had or had not been hospitalized during the acute infection.

“Patients were questioned every two months about the presence during the past period of 53 symptoms of the disease. It’s not that long as it’s not a disease that progresses quickly” explains the Dr. Viet-Thi Tran (epidemiologist, Center for Clinical Epidemiology of the Hôtel-Dieu AP-HP, Paris), co-investigator of the ComPaRe project, at Medscape French edition.

The patients were questioned every two months about the presence during the past period of 53 symptoms of the disease.
Dr. Viet-Thi Tran

Symptoms that diminish, others that appear

Remission, ie the total disappearance of symptoms, was observed in 150 patients. But among the latter, 50 then described a relapse of at least one symptom.

At twelve months, the researchers conclude that the probability of persistence of one or more symptoms is 84.9% (95% CI [79.8–90.4]) “This result is consistent with the observations of a German study (2) in which 20% of patients no longer presented any of the 14 symptoms studied at 12 months” they write.

At twelve months, the researchers conclude that the probability of persistence of one or more symptoms is 84.9%.
Dr. Viet-Thi Tran

The clinical manifestations did not show the same prevalence over time, the researchers found. Thus the prevalence of 27 of the 53 symptoms (51%) decreased. This means that the number of people reporting this problem has gradually decreased over time. This concerned symptoms such as loss of appetite, loss or change in taste or cough. The prevalence of this last symptom went, for example, from 40% of patients with a long Covid, 2 months after the onset of the disease, to around 20% of patients, twelve months after the onset of the disease.

For 18/53 of the symptoms studied, the prevalence did not change over time. Thus, the prevalence of fatigue remained stable over time, as did that of dyspnea and difficulty finding words, which continued to affect respectively 44.5% and 48% of the population twelve months after the onset of the disease. sickness.

Some symptoms tended to return in “attacks” but the researchers noticed that these relapses gradually faded over time.

Finally, for eight symptoms, the prevalence increased over time. That is, the appearance of new manifestations of the disease. Among these symptoms were noted, for example, hair loss, headaches or backaches and paresthesias.

No answer on the mechanisms involved

“The long Covid is a very heterogeneous entity. Different causes can lead to the same symptom,” recalls Dr. Viet-Thi Tran. “If you have pulmonary sequelae, you have every reason to be tired, if you have psychosomatic manifestations, you have every reason to be tired and if you have an immune mechanism with activation of B lymphocytes, you have every reason to be tired,” he explains. “We didn’t try to find out what the mechanisms were. For fatigue, we described tired people. That’s all “.

As for late-onset symptoms such as paresthesias or back pain, they simply have no explanation today, he says.

See the summary table on the next page

Symptom

Prevalence at D60

Prevalence at D360

Difference

Loss of appetite

30.6

6.9

-23.7

Change/loss of taste

46.9

24.1

-22.8

Cough

44.6

21, 8

-22.8

Headache

82.8

63.7

-19.1

Fever

41

22.9

-18.1

Change/loss of sense of smell

46.9

29

-17.9

Diarrhea

38.7

22.9

-15.8

Mood changing

61.1

46.2

-14.9

Dysphagia

33.1

18.3

-14.8

Dry, peeling skin

35.3

21.3

-14

Muscle cramp

54.6

42.2

-12.4

Fatigue

93

81

-12

Dizziness, malaise

55.2

43.3

-11.9

Mental fog, difficulty concentrating

71.8

60.2

-11.6

balance disorder

33.8

22.7

-11.1

Nausea, vomiting

27.6

16.7

-10.9

More sleep

32.5

21.7

-10.8

Tachycardia, palpitations, arrhythmias

43.8

33

-10.8

Feeling of tightness in the chest

44.1

33.7

-10.4

Tremor

23.1

13.6

-9.5

Sleep disorder

70.1

60.8

-9.3

Enlarged lymph nodes

14.8

6.2

-8.6

Skin rash

28

20.1

-7.9

Abdominal pain

41.9

34.4

-7.5

Acute pain in the chest

32.1

24.8

-7.3

memory impairment

55.7

50.2

-5.5

Aches

43.6

38.3

-5.3

Rib pain

29.9

25.8

-4.1

Weightloss

12

7.9

-4.1

Hyper or hypotension

15.3

11.5

-3.8

Tinnitus

38.9

36.1

-2.8

Sweat

20.5

18.3

-2.2

Hot flashes

22.3

20.7

-1.6

Congested nose

33.9

34.1

0.2

Dyspnea

44.2

44.5

0.3

Clogged ear

11.1

11.5

0.4

Difficulty finding words

47.5

48.3

0.8

Gynecological problems

5.2

6.3

1.1

Photo or phonophobia

10.8

12.7

1.9

Circulatory problems

6.1

8.3

2.2

Hematomas

5.7

8.3

2.6

Intolerance to cold or heat

9.2

11.8

2.6

Hypoaesthesia

3.2

5.9

2.7

Dry eye

23.9

28.4

4.5

Urinary symptoms

8.5

13.4

4.9

Discoloration/sweating of hands or feet

6.2

11.3

5.1

Heavy legs

14.3

19.8

5.5

vision problem

26.2

32

5.8

Hair loss

8.2

15.1

6.9

Bone or joint pain

32.2

41.4

9.2

Pain in the ears

5.2

16.9

11.7

Paresthesias

21.1

33.7

12.6

Pain in the neck, back and lower back

23.4

38.5

15.1

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