The UK's growing burden of long-COVID

By Nidhi Saha, BDSDec 15 2022Reviewed by Benedette Cuffari, M.Sc.

A recent study published in the International Forum of Allergy and Rhinology discusses ear, nose, and throat (ENT)-related post-acute symptoms of the coronavirus disease 2019 (COVID-19), of which include vertigo, dyspnea, anosmia, ageusia, and sore throat. Furthermore, post-acute or long COVID symptoms were found to be more common in females and White identifying individuals between the ages of 35-49 years, as well as the disabled.

Study: The growing burden of Long Covid in the United Kingdom: Insights from the UK coronavirus infection survey. Image Credit: Darren Baker / Shutterstock.com

Background

Long COVID refers to prolonged symptoms that persist for more than 12 weeks after recovery from infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several long COVID symptoms have been reported, some of which include headache, myalgia, fatigue, as well as loss of taste and smell. Additionally, parosmia, brain fog, and memory loss have been reported to persist for several months after the initial infection.

Current estimates indicate that long COVID currently affects between 3% and 12% of the population in the United Kingdom. Although post-viral syndromes are widely documented following other types of infection, the scale of long COVID, combined with the rapid spread of SARS-CoV-2, necessitates a better understanding of the epidemiology and risk factors of this syndrome.

The COVID-19 Infection Survey (CIS) is the largest regular survey of COVID-19 and provides essential information to assist the U.K. in response to the pandemic. As a part of the survey, the government was informed on how many people tested positive for COVID-19 in England, Wales, Northern Ireland, and Scotland. This information was subsequently used to assist in decision-making for healthcare policies and public awareness. 

About the study

The current study examines the prevalence of ENT-related symptoms of long COVID and aimed to identify demographic groups at greatest risk for long COVID.

In a longitudinal follow-up program involving patients identified through repeated cross-sectional national surveys, a random sample of volunteers residing in private households was selected. The participants selected were aged two years or older. Children under the age of 12 were surveyed by their parents and caregivers. 

The responses were analyzed between March 6, 2022, and April 3, 2022. The presence of COVID-19 was confirmed by sampling and testing nose and throat swabs, as well as blood tests.

Patients exhibiting COVID-19 symptoms were asked about their symptoms and how their general well-being was affected by the disease on a daily basis. 

Self-reported long COVID syndrome was defined as symptoms persisting for more than four weeks after the first suspected SARS-CoV-2 infection, without being explained by any other factor. With adjustments for age, sex, and region, Bayesian multilevel regression post-stratification was used for the final analysis.

Study findings

ENT-related long COVID symptoms identified in this investigation included vertigo, anosmia, dyspnea, ageusia, and sore throat. The most prevalent complaint was fatigue, while other common symptoms included vertigo, wheezing, rhinorrhea, sneezing, dyspnea, loss of smell, loss of taste, and sore throat. 

Adults aged 35-49 years of White ethnic background had the highest estimated prevalence of self-reported long COVID at 4.13%.  Women had a greater estimated predilection for long COVID than men at 3.20% and 2.34%, respectively.

Conclusions

The current study was based on a large and weighted sample of participants and a longitudinal follow-up period, which contributed to the strength of the study. The study findings indicate that future policies should focus on identifying and aiding the most vulnerable groups in the U.K. by increasing access to treatments for chemosensory disorders and COVID clinics.

However, the likelihood of confounding results could not be ruled out due to the lack of response or follow-up dropouts that impeded validation of long COVID. Furthermore, the prevalence of post-COVID syndrome could have been overestimated by including symptoms only after four weeks after the infection confirmation. 

Additionally, the survey relied on self-reporting. Specific data confirming a connection between rhinorrhea, sneezing, and wheezing symptoms and the individual COVID variants were not available for this analysis.