Post by Nadica (She/Her) on Jul 28, 2024 2:46:00 GMT
Is ‘Long Covid’ similar to ‘Long SARS’? - Published June 9, 2022
BACKGROUND
Severe acute respiratory syndrome
In 2002–03, a Severe Acute Respiratory Syndrome (SARS) coronavirus caused a pandemic. It was described as a novel virus, meaning that it seemed to be unrelated to other viruses directly. Worldwide there were approximately 8000 cases and over 800 deaths. Toronto (Ontario, Canada) had the largest outbreak outside of Asia, with 251 cases and 41 deaths, with health care workers making up 43% of the cases [1].
Covid
The World Health Organisation (WHO) has recorded about 500 million Covid-19 cases and 6 million deaths globally, up to mid-April 2022 [2]. How many people have suffered from Long Covid [also called post acute sequelae of COVID-19 (PASC)]? We have both too much evidence and insufficient evidence. There are many, many articles published. There is incomplete agreement as to criteria for inclusion, symptoms, severity of symptoms and length of time symptoms have persisted. There is the question of what proof of Covid is required (is a self-reported test adequate?) and whether the study setting is in the community or whether it is post hospitalization. In the UK, the official register provides a prevalence of ongoing post-Covid symptoms at about 8% of cases (1.8 million people [3] post 22.3 million cases [4]). A recent Lancet preprint [5] (i.e. preliminary, not yet accepted for publication and without peer review) systematic review and meta-analysis including 196 studies and 120,970 participants showed that long COVID may affect more than half of the patients, after a median of 6 months from the diagnosis. It is expected that with time, the exact numbers will become more clear. However, it is now already clear that the numbers are very significant. To deal with those staggering numbers of people with ongoing Long Covid symptoms, innumerable rehabilitation programs have sprung up. However, since Long Covid is new, there is no knowledge as to what:
Makes a good rehab program for this population;
What is cost-effective;
What services are needed and helpful;
What are the short-term and long-term outcomes with and without rehabilitation?
These questions cannot yet be answered. However, if as seems likely, Long Covid is similar to the long-term outcomes post SARS, then predictions can be made. Since the term ‘Long Covid’ seems to have taken hold, I will retrospectively refer to the collective symptoms post 2003 as ‘Long SARS’. It should be noted that all the Long SARS patients in my experience were ‘severe’, as all our patients were very sick, hospitalized and many went through the ICU. The literature on Long Covid includes all levels of severity from asymptomatic to fatal. Severity of illness has not yet been established as a risk for Long Covid but it remains as a possibility.
BACKGROUND
Severe acute respiratory syndrome
In 2002–03, a Severe Acute Respiratory Syndrome (SARS) coronavirus caused a pandemic. It was described as a novel virus, meaning that it seemed to be unrelated to other viruses directly. Worldwide there were approximately 8000 cases and over 800 deaths. Toronto (Ontario, Canada) had the largest outbreak outside of Asia, with 251 cases and 41 deaths, with health care workers making up 43% of the cases [1].
Covid
The World Health Organisation (WHO) has recorded about 500 million Covid-19 cases and 6 million deaths globally, up to mid-April 2022 [2]. How many people have suffered from Long Covid [also called post acute sequelae of COVID-19 (PASC)]? We have both too much evidence and insufficient evidence. There are many, many articles published. There is incomplete agreement as to criteria for inclusion, symptoms, severity of symptoms and length of time symptoms have persisted. There is the question of what proof of Covid is required (is a self-reported test adequate?) and whether the study setting is in the community or whether it is post hospitalization. In the UK, the official register provides a prevalence of ongoing post-Covid symptoms at about 8% of cases (1.8 million people [3] post 22.3 million cases [4]). A recent Lancet preprint [5] (i.e. preliminary, not yet accepted for publication and without peer review) systematic review and meta-analysis including 196 studies and 120,970 participants showed that long COVID may affect more than half of the patients, after a median of 6 months from the diagnosis. It is expected that with time, the exact numbers will become more clear. However, it is now already clear that the numbers are very significant. To deal with those staggering numbers of people with ongoing Long Covid symptoms, innumerable rehabilitation programs have sprung up. However, since Long Covid is new, there is no knowledge as to what:
Makes a good rehab program for this population;
What is cost-effective;
What services are needed and helpful;
What are the short-term and long-term outcomes with and without rehabilitation?
These questions cannot yet be answered. However, if as seems likely, Long Covid is similar to the long-term outcomes post SARS, then predictions can be made. Since the term ‘Long Covid’ seems to have taken hold, I will retrospectively refer to the collective symptoms post 2003 as ‘Long SARS’. It should be noted that all the Long SARS patients in my experience were ‘severe’, as all our patients were very sick, hospitalized and many went through the ICU. The literature on Long Covid includes all levels of severity from asymptomatic to fatal. Severity of illness has not yet been established as a risk for Long Covid but it remains as a possibility.