At least 65 million people worldwide have prolonged COVID

It is estimated that at least 65 million people worldwide have long-term COVID, and the true number is likely to be higher.

A review of the state of knowledge about this disease estimates that 10% of people infected with SARS-CoV-2 will experience prolonged symptoms. “Currently, diagnostic and treatment options are insufficient and many clinical trials are urgently needed,” concludes the research. According to Brendan Crabb, an infectious disease researcher, this finding should prompt a rethink of policies that allow COVID-19 to spread almost unchecked among people less vulnerable to a severe form of the disease. “If you consider prolonged COVID, we are all vulnerable.”

According to a review published January 13 in the journal Nature Reviews Microbiology It is estimated that at least 65 million people have long-term COVID illness. This estimate is based on a conservative long-term incidence of COVID at 10% of people infected and that there are over 651 million documented cases of COVID-19 worldwide. The number could likely be much higher as there are many more undocumented cases of infection. The incidence is estimated at 10-30% of non-hospitalized cases, 50-70% of hospitalized cases and 10-12% of vaccinated cases.


The highest percentage of diagnoses occur between the ages of 36 and 50, and most cases of prolonged COVID occur in non-hospitalized patients with a mild acute illness. The authors document that prolonged COVID “covers multiple adverse outcomes, with common illnesses of recent onset, such as cardiovascular, thrombotic and cerebrovascular diseases, type 2 diabetes, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and dysautonomia, especially postural orthostatic tachycardia syndrome (POTS). ) . Symptoms can last for years and, especially in new-onset MS/CFS and dysautonomia, are expected to last a lifetime“. A significant proportion of people with prolonged COVID are unable to return to work.

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Clinicians unfamiliar with ME/CFS and dysautonomia often misdiagnose mental disorders in patients; four out of five patients with POTS receive a diagnosis of a psychiatric or psychological disorder before receiving a diagnosis of POTS.

No treatment for prolonged COVID

While currently the health issues of prolonged COVID do not have validated effective treatments. Many strategies used in ME/CFS are effective for people with long-term COVID, including stimulation and symptom-specific drug options (eg, β-blockers for POTS, low-dose naltrexone for neuroinflammation, and intravenous immunoglobulin for immune dysfunction) such as as well as non-drug options (including increased salt intake for POTS, cognitive stimulation for cognitive dysfunction, and elimination diets for GI symptoms). It is important to emphasize that physical exercise is harmful for most patients and should not be used as a treatment.

The various risk factors include being female, suffering from some illnesses like diabetes, or having a low income and not being able to rest properly in the first few weeks after developing COVID-19.

The review authors suggest that similarities with other viral-onset illnesses, such as myalgic encephalomyelitis/chronic fatigue syndrome and postural orthostatic tachycardia syndrome, lay the groundwork for research and point to the need for clinical trials of treatments.

As a person reinfected with the virus is just as likely to contract prolonged COVID, Professor Brendan Crabb, an Australian infectious disease researcher, said the Nature review should prompt us to rethink the lax attitude towards COVID-19. In the face of prolonged COVID, we are all vulnerable, and that means rethinking healthcare planning.


Nature Reviews Microbiology

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