Friday, April 01, 2022

What are the chances of getting "long COVID"?

Wr are currently vacationing in an eco-resort in an obscure part of Nicaragua. Which is lovely, but to get here we needed to fly to Libéria, Costa Rica and then take two cars across the Nicaragua border, so we were a bit concerned about contracting COVID, of course, even though many another seem to have really lowered their guard. Once here, we can control out contacts pretty easily, but on the flight (and particularly at the airports) one is largely at the mercy of fate, however careful on is.

Now, maybe we shouldn't be quite so paranoid about it - after all, recent variants are not as virulent as earlier ones, even if they are easier to catch, and it would also give us some level of  immunity for the future - bu tthe more I read about "long COVID", or "post COVID-19 condition" as the WHO insists of calling it, the more paranoid I get. Months, possibly years, with extreme fatigue, shortness of breath, "brain fog", joint pain, loss of taste and smell, it all spends pretty unpleasant, and I would really like to avoid it if possible. So, if we are the only ones on the beach shuttle wearing a mask, then so be it, I'm OK with that.

But, much as I have read about it, I am still not sure what the likelihood is of getting long COVID. Is it common? Is the chance vanishingly small? Different research seems to yield wildly differing conclusions, partly because defining long COVID is not easy, partly because the symptoms are so variable, partly because the studies that have been done use different methods and parameter, partly because such studies are very difficult to control, and partly because thus thing is still going on in real time. Estimates vary from less than 5% to nearly 60%!

So, what gives? As one expert put it, "what has been grouped together as 'long COVID' is actually two or three different groups of disorders", which makes any kind of analysis pretty hard. Some have different symptoms, some affect populations differently, and some linger for different periods of time. 

What is reasonably clear, though, is that a more severe case of COVID, including hospitalization, intensive care or ventilator use, where organs may be damaged and the immune system may be compromised, is more likely to lead to long COVID. By extension, the incidence of long COVID is much lower in vaccinated people, mainly because their vaccination protects them from more serious symptoms. By some estimates, vaccination reduces the chances of long COVID by 80-90%. Even the virus' morph to the less virulent Omicron variance does not necessarily mean less incidence of long COVID. There seems to be little to suggest that the prevalence of the Omicron variant is any less likely to lead to long COVID cases, milder symptoms or not.

For people who have been hospitalized with COVID, lingering symptoms for 6 months or more may have a likelihood of over 50% according to some studies. Other studies have concluded that even mild cases can result in up to 60% likelihood of lingering symptoms! A UK study, on the other hand, concluded that the incidence of long COVID was closer to 5%. Mind you, given the numbers of cases - now approaching half a BILLION - 5% is still a awful lot of people with a nasty chronic condition. I don't plan to join them.

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