COVID-19 Resource Center

COVID-19 Resource Center

Perspective from Kathleen Bell, MD
Disclosures: Healio Primary Care could not determine the authors’ relevant financial disclosures at the time of publication.
March 19, 2021
1 min read
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Many COVID-19 ‘long-haulers’ are initially asymptomatic

Perspective from Kathleen Bell, MD
Disclosures: Healio Primary Care could not determine the authors’ relevant financial disclosures at the time of publication.
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About one-third of patients who reported having COVID-19 symptoms weeks after diagnosis were initially asymptomatic, according to a preprint study in medRxiv.

“Asymptomatic individuals may be less often intensely monitored due to an inherent notion of low risk for severe acute disease; however, this is problematic as asymptomatic individuals account for 32% of the long-haulers observed in this study,” Yong Huang, a PhD student at the Sue & Bill Gross School of Nursing at the University of California Irvine, and colleagues wrote.

The most common symptoms among “long-haulers” after 60 days of COVID-19 diagnosis are chest pain, dyspnea, anxiety, abdominal pain, cough, low back pain and fatigue.
Reference: Reference: Huang Y, et al. medRxiv. 2021;doi:10.1101/2021.03.03.21252086.

Recent data indicate that about 10% of patients hospitalized with COVID-19 become “long-haulers,” the researchers wrote. They added that research in “long-haulers,” especially the 99% of cases that do not require hospitalization, is lacking. Therefore, Huang and colleagues analyzed electronic health records from 1,407 patients of all age groups within the University of California COVID Research Data Set who were not hospitalized for the condition.

Twenty-seven percent (n = 382) of “community dwelling” patients with COVID-19 had persistent symptoms that lasted more than 60 days after diagnosis and were considered “long-haulers,” Huang and colleagues wrote. Of these patients, the most common symptom was chest pain, followed by dyspnea, anxiety, abdominal pain, cough, low back pain and fatigue.

Women and members of underrepresented groups were more likely to become “long-haulers,” according to the researchers. More than 72% of “long-haulers” were aged 50 ± 20 years, and 34 were aged younger than 18 years (mean age = 9.29 years).

The researchers reported that many “long-haulers” — approximately 32% — did not have symptoms at the time of testing for SARS-CoV-2.

“Age distribution of all SARS-CoV-2 infected individuals at day 0-11 very closely mimicked that of the long-haulers, suggesting the latter group are distributed across all age groups,” Huang and colleagues wrote. “Although our study supported a potential association with female sex and higher likelihood of becoming a long-hauler, race appeared to be less predictive for both Caucasian and Hispanic ethnicity.”

The researchers noted that “long-haulers represent a very significant public health concern, and there are no guidelines to address their diagnosis and management.”

They said that more research is needed to better understand the emotional, mental and physical impact of persistent COVID-19 symptoms.