Long COVID Is Just Like Other Post-Viral Syndromes, Health Chief Argues

Long COVID is real, as are the experiences of those who suffer with lasting symptoms after a bout of the illness. But according to new data, it may not be a unique condition. At an upcoming conference, a team including the Chief Health Officer for the state of Queensland, Australia, will present evidence suggesting there is no substantive difference between long COVID and other post-viral syndromes. 

What does the study say?

The team gathered data from over 5,000 Queenslanders aged 18 and over, all of whom had respiratory symptoms that had necessitated a PCR test for COVID-19 and influenza. Within the group, just under half had a confirmed positive COVID test result. The others were split between those testing positive for flu instead (995 people) and those testing negative for both infections (1,718).

The initial testing was done in May and June of 2022, around the peak of the flu season in Australia.

The participants were then followed up a year later and asked to fill in a questionnaire about any ongoing symptoms they were experiencing. A total of 16 percent of respondents still had lingering issues at that time, with 3.6 percent reporting a “moderate-to-severe” impact on their daily lives.

Analyzing the data, the scientists controlled for factors like age, sex, and First Nation status, all of which could have an impact on the likelihood of long COVID or post-viral syndrome. They found that there was no significant difference in the rates of lasting symptoms between those who had confirmed COVID-19, those who had flu, and those who had a respiratory disease of unknown cause.

In other words, they suggest you may be just as likely to develop ongoing issues after a bout of the flu or a cold as you would be after COVID-19.

“In health systems with highly vaccinated populations, long COVID may have appeared to be a distinct and severe illness because of high volumes of COVID-19 cases during the pandemic,” said Queensland’s Chief Health Officer Dr John Gerrard in a statement. “These findings underscore the importance of comparing post-COVID-19 outcomes with those following other respiratory infections, and of further research into post-viral syndromes.”

What could these findings mean?

Many would argue that post-viral syndromes are a neglected area of research, to the detriment of patients. The experiences of those who developed long COVID, particularly in the early days of the pandemic when the condition had not been formally recognized, brought renewed attention to the plight of those with similar conditions like ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), many of whom have been advocating for improved awareness and treatment options for decades.

“[T]he problem is that there are millions upon millions of very sick, very debilitated individuals with these diseases and it’s going to take a moonshot [because] these diseases historically have been at the end of the queue for funding,” said Billy Hanlon, director of advocacy and outreach for the Minnesota ME/CFS Alliance, speaking to Amsterdam News.

Hanlon developed ME/CFS in 2017 after a seemingly minor viral infection, a story that will be familiar to many sufferers of long COVID, whose initial brush with the virus is often mild. 

Insofar as the new research from Queensland highlights the need for long COVID to be considered as part of a broader umbrella of post-viral conditions that require greater support and research funding, some other experts have voiced their agreement.

“This abstract reveals a significant finding: approximately 4 percent of individuals, irrespective of the virus they contracted, may experience persistent health issues post-infection, resulting in chronic incapacitation. This implies that Long COVID is not a standalone condition but rather part of a broader spectrum of post-viral syndromes,” said Marie-Claire Seeley, a Clinical Nurse Consultant, who was not directly involved in the study.

However, others have called into question some elements of the methodology, and have criticized one of the more controversial suggestions from the study team: that the term “long COVID” is itself unhelpful and can cause, as Gerrard put it, “unnecessary fear”.

Professor Jeremy Nicholson, from Murdoch University, argued that without more detailed patient data, it’s not possible to claim that long COVID is “indistinguishable” from other post-viral syndromes.

“The absence of evidence is different from evidence of absence – so the authors’ assertion that Long COVID is the same as flu-related post viral syndrome, is not proven, even if Long COVID is indeed a post-viral syndrome (which it is),” said Nicholson.

Professor Philip Britton, who is a member of the Long COVID Australia Collaboration, commented, “There are likely reasons why persistent symptoms following COVID in this Queensland cohort may be no more frequent than following other viruses including the predominantly vaccinated cohort and the high frequency of Omicron variants. These factors are acknowledged by the authors.”

“It is because of these specific factors as well as inherent limitations of the study methodology itself, that their conclusion that it is ‘time to stop using terms like “long COVID”’ is overstated and potentially unhelpful. Long COVID has been a global phenomenon, recognised by WHO.”

Today, March 15, 2024, marks the second annual International Long COVID Awareness Day, the theme of which is “Confront Long COVID.” In the lead up to the conference presentation and likely for some time thereafter, this research will spark disagreement and debate; but, as Britton pointed out, the fact that people are talking about the condition at all is a good thing.

“Studies like this are reassuring that most people will recover from COVID without long-term effects and further, with vaccination and viral evolution, the number of people who experience Long COVID will likely reduce with time. This is good news!” Britton said.

“I welcome the results of this study given the lack of published research from Australia in this area.”

The study will be presented at the European Congress of Clinical Microbiology and Infectious Diseases 2024

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