The data are based on a study of 428 long-term COVID patients treated in outpatient clinics after COVID-19 between March 2020 and June 2021, with both the original SARS-CoV-2 strain and the Alpha variant in circulation.  It suggests that those infected with the Alpha variant experienced different neurological and emotional symptoms compared to those infected with the original SARS-CoV-2 strain.
When the Alpha variant was the predominant strain, there were more cases of muscle aches and pains, insomnia, brain fog and anxiety and depression among patients with COVID-19.  Meanwhile, symptoms such as loss of smell, difficulty swallowing and impaired hearing were less common.
However, infectious disease experts question the accuracy of the study and point to difficulties in assigning specific long-term symptoms of COVID to different variants.
Dr. Christopher Carlsten is the Head of Respiratory Medicine at the University of British Columbia.  Although he praises every effort to better understand COVID-19, he is not yet convinced that the Alpha variant leads to a worse COVID-19-related syndrome than other variants.
“It’s a retrospective observational study, which always raises questions of bias regarding whether [this] “It’s actually due to the Alpha variant or it’s due to some other factors that accompanied the Alpha variant,” he told CTVNews.ca in a March 30 phone interview.  any of them and claim that the variable as the cause of a pattern is dangerous “.
The study was published in an early press release ahead of the European Conference on Clinical Microbiology and Infectious Diseases conference later this month.
Looking at the study design, it also appears that the researchers did not confirm which variant of the virus caused the infection in which patients, said Dr. Nazeem Muhajarine, an epidemiologist at the University of Saskatchewan.  In contrast, patients were evaluated based on whether they were infected when the original strain was dominant or when the Alpha variant was dominant.  This raises doubts about the accuracy of the study, Muhajarine said.
“This is a big restriction,” he told CTVNews.ca in a telephone interview on March 30.  “You really do not know if you do not really take a sample and do this genomic sequence and find out [whether] this person was infected with Alpha [or] the original virus.
“I’m a little convinced that certain prolonged symptoms can be associated with a specific variant of SARS-CoV-2.”
However, Muhajarine said this remains a key area of ​​interest among COVID-19 researchers and that larger-scale studies will be needed to get a clearer picture of the causes and effects of long-term COVID-19.  The study authors also say more research is needed to better understand long-term COVID, as much remains unknown about the condition.
WHAT DO WE KNOW SO LONG ABOUT LONG COVID?
Prolonged COVID-19, also known as the meta-acute consequence of COVID-19 (PASC), occurs when the symptoms of an initial COVID-19 infection persist for more than about 12 weeks after infection, Muhajarine said.  At this point, experts would generally expect the symptoms to have subsided.  As a result, someone with long-term COVID-19 would not necessarily be positive for the virus when using PCR or rapid antigen testing, Carlsten said.
“When this symptom persists beyond the infection, it means that the bug is no longer active to the extent that we can measure it and you continue to have symptoms; I would consider this a long-term COVID,” Carlsten said.
As described in the study, long-term COVID has been diagnosed in both young and elderly patients, as well as those generally considered healthy and those with underlying health conditions.  A recent study suggests that approximately 30 percent of those infected with COVID-19 will continue to develop long-term symptoms.  However, the exact rate is still unclear as population-based studies assessing the prevalence of long-term COVID have not yet emerged, Muhajarine said.
However, the situation is real and has the potential to affect a significant number of people, Carlsten said.
“Even moderate rates of COVID patients with long-term symptoms are many people,” he said.  “Instead of dwelling too much on this point with the exact percentage, it is quite clear that it is a non-trivial percentage and that at the population level, it means a lot of people.”
With the recent introduction of Omicron, the idea of ​​the long-term development of COVID in those infected with the latest variant of concern is possible, Carlsten said.
“The basic answer is yes – for me, there is no doubt that Omicron can lead to long-term COVID,” said Carlsten.  “I think the question is how much and there I have the opposite answer, which is that I do not know and I do not know that anyone can tell you at this point.”
Given that people only knew about the Omicron variant for a few months, Muhajarine said it would take more time to determine the link between Omicron and long-term COVID, and whether a different set of long-term COVID symptoms could be linked to this variant. when compared to the previous ones.
“We are exactly on this threshold as to whether Omicron leads to longer COVIDs and whether it leads to longer COVIDs compared to previous variants,” he said.  “I think we have to give him a few more weeks and months to really be able to say that because I think we’re really on the verge of even that definition of what COVID is.”
According to Carlsten, the concept of different symptoms associated with different variants of COVID-19 is not new.  This is due to small differences in the amount and types of mutations that each variant retains, which can cause different symptoms to occur once a person becomes infected, Muhajarine said.  However, these differences are not usually striking, Carlsten said.
“During a pandemic, there appear to be more similarities in COVID-related symptoms than differences per strain,” he said.
GENERALIZED SYMPTOMS AN OBSTACLE TO DIAGNOSIS
Commonly reported symptoms of long-term COVID are shortness of breath, chronic fatigue, sleep problems, vision problems, and brain fog.  Elevated heart rate also appears to be associated with prolonged COVID-19.  An international study suggests that up to 203 symptoms could be associated with prolonged COVID-19, with the most common being fatigue, exhaustion and cognitive impairment.
One of the challenges in understanding the cause of long-term COVID is that many of the symptoms associated with it are rather generalized, Carlsten said.
“The fundamental annoying nature of long-term COVID is that there is not a single symptom that is specific or even remotely specific,” he said.  “They are almost, by definition, symptoms that are very common in other diseases and other medical problems.”
This also makes it extremely difficult to diagnose and treat the condition, Carlsten said.
“The key to a diagnosis is that the more specific the features, the easier it is to diagnose,” Carlsten said.  “But because these are non-specific, it makes diagnosis more difficult and treatment accordingly more difficult.”
There is no single test used to diagnose long-term COVID, Muhajarine said, although some tests can be used to detect common symptoms, such as blood tests, heart rate and blood pressure tests, electrocardiograms and chest x-rays.  There does not appear to be any cure or cure for long-term COVID, he said, although experts are beginning to try to address the issue.  So far, the focus seems to be on treating some of the symptoms associated with long-term COVID rather than the condition itself, Muhajarine said, which may include rehabilitating patients to help with breathing and lung function. example.
The National Institute for Excellence in Health and Care in the United Kingdom, which provides national guidance for improving healthcare, has put forward a proposal for the management and treatment of long-term COVID that includes a step-by-step approach.  This begins with patient-led self-care-based rehabilitation and progresses to recovery under the guidance of a general practitioner or specialist, depending on the severity of the condition.  Muhajarine said he could see this as an effective approach to managing long-term COVID in Canadian patients as well.
“AT THE START GATE” OF LONG COVID MANAGEMENT
As restrictions continue to be lifted in parts of Canada, this may give people the idea that COVID-19 is a thing of the past, but that is not the case with Muhajarine, especially when considering the possibility of a long COVID-19.  As a result, Carlsten said, it is important that we continue to work to better understand the situation.
“It’s a huge issue that we need to keep trying to understand,” Carlsten said.  “I think we need to stick to the research, despite the fact that, in terms of long-term COVID, it was not incredibly revealing, because it is a huge problem at the population level.”
Muhajarine also calls on healthcare systems to open more outpatient clinics for COVID-19 patients.  Provinces like Ontario and British Columbia have long had COVID-19 clinics, but provinces like Saskatchewan do not, Muhajarine said.
“We are still really at the gateway to tackling long-term COVID in this country, unfortunately,” he said.  “We hear stories from people who have long-term symptoms of COVID and just feel left out and dry to deal with it on their own.
“This is the…