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New Evidence Reveals Most Common Long-term COVID-19 Symptoms among Health Care Workers


Fatigue was among the most common symptoms that health care workers in Sweden reported 8 months after mild COVID-19 infection, according to a new research letter.

©Robert Kneschke/stock.adobe.com

©Robert Kneschke/stock.adobe.com

Loss of smell, loss of taste, dyspnea, and fatigue are the 4 most common symptoms that health care professionals in Sweden report 8 months after mild coronavirus disease 2019 (COVID-19) infection, according to research letter published online April 7, 2021, in JAMA.

“We investigated the presence of long-term symptoms after mild COVID-19 in a relatively young and healthy group of working individuals, and we found that the predominant long-term symptoms are loss of smell and taste. Fatigue and respiratory problems are also more common among participants who have had COVID-19 but do not occur to the same extent,” said senior author Charlotte Thålin, MD, PhD, department of clinical sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden, in a press release.

“We do not see an increased prevalence of cognitive symptoms such as brain fatigue, memory and concentration problems or physical disorders such as muscle and joint pain, heart palpitations or long-term fever,” added Thålin.

The findings are part of the ongoing COVID-19 Biomarker and Immunity (COMMUNITY) study that examines long-term immunity after mild COVID-19. Health care professionals at Danderyd Hospital were invited to enroll in the COMMUNITY study between April 15-May 8, 2020.

Blood samples are collected from the participants every 4 months. Demographics, symptoms and severity (mild or severe), and chronic diseases were obtained through participant questionnaires at baseline. Participants who were seropositive for SARS-CoV-2 anti–spike IgG at baseline and who reported severe symptoms were excluded, as were initially seronegative participants who seroconverted during follow-up.

Thålin and colleagues compared symptom reporting between 323 health care workers (83% women; median age, 43 years) who had mild COVID-19 at least 8 months earlier with 1072 health care workers (86% women; median age, 47 years) who did not have COVID-19 throughout the study.

At the 8-month follow-up, participants reported the presence, duration, and severity of 23 predefined symptoms via a smartphone app. Researchers used the Sheehan Disability Scale to gauge functional impairment from long-term COVID-19 symptoms.


The results showed that 1 in 10 of participants with mild COVID-19 experienced ≥1 moderate-to-severe COVID-19 symptoms that negatively impacted their quality of life.

Researchers found that 26% of seropositive health care workers, as compared to 9% in the control group, had at least 1 moderate-to-severe symptom that lasted >2 months. Also, 11% of seropositive participants reported at least 1 symptom that negatively affected their work, social, or home life at 8 months vs 2% of the control group.

"Despite the fact that the study participants had a mild COVID-19 infection, a relatively large proportion report long-term symptoms with an impact on quality of life,” said co-author Sebastian Havervall, MD, deputy chief physician, Danderyd Hospital, PhD student in the project at Karolinska Institutet, in the press release. “In light of this, we believe that young and healthy individuals, as well as other groups in society, should have great respect for the virus that seems to be able to significantly impair quality of life, even for a long time after the infection."

Thålin and colleagues plan to continue the COMMUNITY study, with the next follow-up to take place in May 2021 when a large proportion of participants are expected to be vaccinated.

“We will, among other things, be studying COVID-19-associated loss of smell and taste more closely, and investigate whether the immune system, including autoimmunity, plays a role in post-COVID," concluded Thålin in the press release.

For additional information on long COVID-19, please see Long COVID Review Lead Author Highlights Knowns, Unknowns.

And for additional information on lasting neurological symptoms, please see Novel Study Finds Mild COVID-19 Associated with Prominent, Persistent Neurologic Symptoms.

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