(Press-News.org) Long COVID, or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), includes a wide range of symptoms that present or persist more than 30 days after COVID-19 infection. With over 650 million people globally having been infected with SARS-CoV-2, long COVID represents a significant public health concern that affects quality of life, earnings, and health care costs. To better understand the prevalence and severity of symptoms, the National Institutes of Health (NIH) launched Researching COVID to Enhance Recovery (RECOVER-Adult), with Mass General Brigham researchers leading the statistical analysis for the study. Results from RECOVER, one of the largest NIH studies ever funded, elucidate 12 defining symptoms of long COVID. The findings, published in JAMA, include a new scoring system for long COVID to help clinicians and researchers better define it and investigate treatments for patients.
“Now that we’re able to identify people with long COVID, we can begin doing more in-depth studies to understand the biological mechanisms at play,” said corresponding author Andrea Foulkes, ScD, Principal Investigator of the RECOVER Data Resource Core (DRC), Professor at Harvard Medical School, and Director of Biostatistics at Massachusetts General Hospital (MGH), a founding member of Mass General Brigham. “One of the big takeaways from this study is the heterogeneity of long COVID: long COVID is not just one syndrome; it’s a syndrome of syndromes. Understanding this idea is a really important step for doing more research and ultimately administering informed interventions."
While researchers have documented a wide range of symptoms across organ systems that affect individuals after a COVID-19 illness, many studies are limited by a retrospective design, reliance on electronic health record entries, and lack of an uninfected comparison group. Therefore, there remains significant disagreement over how common and/or severe certain long COVID symptoms may be, and what patterns of symptoms define long COVID.
RECOVER-Adult, a prospective study that began enrolling participants in October 2021, has sought to harmonize data acquisition and build a data-backed definition for long COVID. Researchers from Mass General Brigham, the RECOVER DRC, analyzed the results of a symptoms survey distributed at 85 hospitals, health centers, and community organizations in 33 states, Washington, D.C., and Puerto Rico. Over 9,500 individuals completed the survey, including uninfected adults as well as individuals who were six months past infection with COVID-19. The survey, developed in collaboration with clinicians and patient advocates, included 37 different symptoms and corresponding measures of severity.
Ultimately, 12 symptoms emerged as hallmarks of long COVID, including post-exertional malaise (debilitating fatigue that is exacerbated by physical or mental activity), loss of or change in smell or taste, dizziness, brain fog, gastrointestinal symptoms, palpitations and chronic cough. While the researchers found that some of the symptoms, like post-exertional malaise, are experienced by most people with long COVID, others, like loss of or change in smell and taste, are less common but still important for identifying individuals with long COVID. A simple algorithm developed by the researchers assesses these 12 symptoms to generate an overall “PASC score,” but the authors emphasize that an individual with symptoms excluded in the scoring system may still suffer from long COVID and nonetheless deserves high-quality care.
Finally, results suggest that re-infections, infection with a pre-Omicron SARS-CoV-2 variant, and absence of vaccination is associated with a higher frequency and severity of long COVID, but the authors emphasize that ongoing research is necessary. Future studies from the RECOVER Consortium will analyze risk factors for long COVID, including social determinants of health. The researchers are also examining how long COVID may manifest in children, adolescents, and in people who were pregnant during SARS-CoV-2 infection.
“This is a truly data-driven approach to defining long COVID as a new syndrome,” said first author Tanayott Thaweethai, PhD, Co-investigator for the RECOVER DRC, Instructor at Harvard Medical School, and an Associate Director at MGH Biostatistics. “We now have a definition for long COVID where there hasn’t been one previously, and we hope the ability to identify long COVID will enhance clinical awareness of this condition.”
Disclosures: Foulkes receives research support from the NIH and is contact Principal Investigator of the RECOVER Data Resource Core. Thaweethai receives research support from the NIH and is co-Investigator on the RECOVER Data Resource Core.
Funding: This research was funded by the National Institutes of Health (NIH) Agreement OTA OT2HL161841, OT2HL161847 and OT2HL156812 as part of the Researching COVID to Enhance Recovery (RECOVER) research program. The content is solely the responsibility of the authors and does not necessarily represent the official views of the RECOVER Program or the NIH. The RECOVER DRC is co-led by Shawn Murphy, MD, PhD of MGH, and Elizabeth Karlson, MD, MS, of Brigham and Women’s Hospital.
Paper cited: Thaweethai, T et al. “Characterizing Post-Acute Sequelae of SARS-CoV-2 (PASC): Early Findings of the RECOVER Adult Cohort Study” JAMA DOI: 10.1001/jama.2023.8823
The National Institutes of Health Researching COVID to Enhance Recovery (NIH RECOVER) Initiative is a $1.15 billion effort, including support through the American Rescue Plan Act of 2021, that seeks to identify how people recuperate from a COVID-19 infection, and who are at risk for developing post-acute sequelae of SARS-CoV-2 (PASC). Researchers are also working with patients, clinicians, and communities across the United States to identify strategies to prevent and treat the long-term effects of COVID – including long COVID. For more information, please visit recovercovid.org.
About Mass General Brigham
Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals. For more information, please visit massgeneralbrigham.org.
About The Study: In this analysis of data from 9,764 participants in the RECOVER adult cohort, a prospective longitudinal cohort study, 37 symptoms across multiple pathophysiological domains were identified as present more often in SARS-CoV-2–infected participants at six months or more after infection compared with uninfected participants. A preliminary rule for identifying postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID, was derived based on a composite symptom score. As a first step to providing a framework for other investigations, iterative refinement that further incorporates other clinical features is needed ...
Researchers from the Quadram Institute and University of East Anglia have identified what makes some strains of gut bacteria life-threatening in pre-term babies.
The findings will help identify and track dangerous strains and protect vulnerable neonatal babies.
A major threat to neonatal babies with extremely low birth weight is necrotising enterocolitis (NEC).
Rare in full term babies, this microbial infection exploits vulnerabilities destroying gut tissue leading to severe complications. Two out of five cases are fatal.
One bacterial species that causes especially sudden and severe disease is Clostridium perfringens. These ...
Surface electromyography (EMG) has been widely used to measure the electrical activity of muscles. However, the variability in EMG sensing signals due to biological differences of different users significantly degrades the performance and potential of EMG systems. Recently, researchers from City University of Hong Kong (CityU) developed a deep learning-based framework called EMGSense, which can achieve high sensing performance for new users using AI self-training techniques. This opens a new path for developing more advanced and accurate wearable EMG devices in areas like neurorehabilitation and virtual reality.
Insilico Medicine (“Insilico”), a generative artificial intelligence (AI)-driven clinical stage drug discovery company, today announced that the U.S. Food and Drug Administration (FDA) recently approved the initial investigational new drug (IND) application for ISM3091 for the treatment of patients with solid tumors. This is Insilico's first oncology program to advance to the clinical validation stage.
The open-label, multicenter Phase I clinical trial of ISM3091 will be conducted simultaneously in the U.S. and China ...
Scientists in Finland have developed a nanodevice that can measure the absolute power of microwave radiation down to the femtowatt level at ultra-low temperatures – a scale trillion times lower than routinely used in verifiable power measurements. The device has the potential to significantly advance microwave measurements in quantum technology.
Measuring extremely low power
Quantum science takes place mostly at ultra-low temperatures using devices called dilution refrigerators. ...
An early advocate for the electronic health records now found in hospitals across the country has developed a plan to improve their use, lighten clinicians’ workload and enhance patient care.
The University of Virginia School of Medicine’s Don Detmer, MD, MA, designed the improvement plan in collaboration with Andrew Gettinger, MD, of Dartmouth’s Geisel School of Medicine. Detmer oversaw UVA’s adoption of electronic physician order entry in the early 1990s while vice president ...
When we talk about defects, we generally think of flaws or impairments. However, as far as materials science is concerned, defects represent windows of opportunity. A new Collaborative Research Center (CRC) in the field of soft matter based at and administered by Johannes Gutenberg University Mainz (JGU) will explore these opportunities. The German Research Foundation (DFG) has approved CRC 1552 "Defects and Defect Engineering in Soft Matter" and will be providing funding of some EUR 8 million over the next four years. Also participating are the Max Planck Institute for Polymer Research and the Fraunhofer Institute for Microengineering and Microsystems ...
Scientists have made a significant advancement with quantum technologies that could transform complex systems modelling with an accurate and effective approach that requires significantly reduced memory.
Complex systems play a vital role in our daily lives, whether that be predicting traffic patterns, weather forecasts, or understanding financial markets. However, accurately predicting these behaviours and making informed decisions relies on storing and tracking vast information from events in the distant past – a process which presents huge challenges.
Current models using artificial intelligence see their ...
Current cancer diagnoses compared with pre-pandemic rates: Researchers quantified missed diagnoses of lung, breast, and colorectal cancers by comparing observed cancer rates in 2020 with pre-pandemic cancer rates (2010-2019).
Potential increase in undiagnosed disease: Incidence rates for all three types of cancer have significantly decreased, suggesting that many patients may currently harbor undiagnosed disease.
Importance of screening: Study adds to the growing body of literature on pandemic-related disruptions and serves as a vital reminder to encourage all patients to stay up to date on their recommended cancer screenings.
Nearly $13 million in federal grant funds to study treatments for traumatic brain injury, which kills an average of 190 people and hospitalizes another 600 in the U.S. every day, has been awarded to UTHealth Houston by the Department of Defense’s Office of Congressionally Directed Medical Research Programs (CDMRP).
The funding marks a positive step forward for patients suffering from the medical condition, said Charles S. Cox Jr., MD, the George and Cynthia Mitchell Distinguished Chair in Neurosciences and the Glassell Family Distinguished Chair in the Department of Pediatric Surgery with McGovern ...