Tuesday, March 21, 2023
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Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine
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Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
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Health Sciences Clinical Professor of Family Medicine
University of California, Irvine School of Medicine
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Everyone has their own particular concerns regarding COVID-19. Although hospitalization and even death related to severe COVID-19 are usually at the top of the list, long COVID remains a substantial concern as well. Research into the pathogenesis and epidemiology of long COVID continues to evolve; however, it is clear that long COVID takes a considerable toll on health-related quality of life (HRQoL).
One of the major questions regarding long COVID is the efficacy of vaccination against prolonged symptoms among adults who acquire COVID-19. A study by Al-Aly and colleagues, which was published in the May 25 issue of Nature Medicine,[1] used large cohorts of adults in the Veterans Affairs health system to answer this question.
Compared with contemporary controls without COVID-19, vaccinated adults who had COVID-19 experienced HRs of 1.75 (95% CI: 1.59, 1.93) for death and 1.5 (95% CI: 1.46, 1.54) for long COVID; however, when vaccinated adults with breakthrough COVID-19 were compared with unvaccinated adults with COVID-19, persons with breakthrough infections experienced reduced HR for death (0.66 [95% CI: 0.58, 0.74]) and long COVID (0.85 [95% CI: 0.82, 0.89]).
It appears that the Omicron variant is associated with a lower rate of severe disease compared with the Delta variant. How do these 2 important variants compare in their risk for long COVID? The current study by Antonelli and colleagues addresses this question.
The Omicron variant of SARS-CoV-2 poses about half the risk for long COVID as the Delta variant, according to a new study published in The Lancet.[2]
At the same time, about 5% of people who contract Omicron still experience symptoms such as brain fog, fatigue, headaches, heart problems, and other health issues at least a month after getting infected. The study is considered one of the first large-scale reports about the long-term risks for Omicron.
"The basic question that we're trying to answer is: 'Is long COVID as common... in the Delta period [as it is] in the Omicron period?" Claire Steves, one of the study authors and a genetic epidemiologist at King's College London, United Kingdom, told NPR.[2]
"What's the risk of going on to get long COVID, given the different variants?" she said.
Steves and colleagues have been tracking thousands of people who tested positive for COVID-19 to determine the risks for long COVID with different variants. They compared more than 56,000 people in the United Kingdom who caught Omicron between December 2021 and March 2022 with more than 41,000 people in the United Kingdom who caught Delta between June 2021 and November 2021.
The patients tracked their symptoms using the COVID Symptom Study app. Persons who caught Omicron were about half as likely as persons who caught Delta to still experience health problems a month later. The chance of developing long COVID from Omicron was 4.5% compared with 10.8% from Delta.
The reduced risk is "great news," Steves said, especially because Omicron is so contagious that many people have been infected quickly. If the risk of contracting long COVID were the same as the Delta variant or higher, the number of people with long COVID would have exploded, she said, but the lower risk does not mean people should not worry about long COVID, she warned.
"The caveat is that the Omicron variant has spread very rapidly through our populations, and therefore a very much larger number of people have been affected," Steves said. "So, the overall absolute number of people who are set to go on to get long COVID, sadly, is set to rise."
The study did not address why Omicron carries a lower risk for long COVID, although Steves said it makes sense because the variant also tends to have a lower risk of making people severely ill.
Long COVID experts told NPR that future studies should confirm the data in medical clinics, and the findings should inform public health measures.
"We're saying, you know: 'You can take off your masks in airplanes. You don't need to be vaccinated anymore to enter a restaurant.' All of these policy decisions are going to increase the likelihood that people get infected with COVID, while there's still a 5% chance of severe chronic illness," David Putrino, PhD, who treats patients with long COVID at Mount Sinai in New York, New York, told NPR.
"That's short-sighted and going to create a lot of long-term disability that did not need to exist," he said.
