Self-reported long COVID symptoms not identified in diagnostic tests

By Dr. Liji Thomas, MDJul 12 2023Reviewed by Benedette Cuffari, M.Sc. The rapid transmission of the severe acute respiratory syndrome coronavirus 2 has caused hundreds of millions of infections and approximately seven million deaths from coronavirus disease 2019 worldwide. The vast amount of research dedicated to understanding COVID-19 has demonstrated that this infection is often accompanied by clinical features related to other organs than the lungs.

Long COVID is estimated to affect up to half of all people with a history of non-severe COVID-19; however, the actual prevalence has not been established. What did the study show? Of the almost 90 symptoms in the questionnaire, over 40 were associated with prior infection. Conversely, objective changes occurred in very few of the over 150 tests of physical and cognitive parameters or blood composition.

For seven symptoms, a temporal trend was observed with improved smell and taste over time but more exertion-related tiredness. Most symptoms, except for skin rash, that were associated with SARS-CoV-2 were also more common with severe COVID-19. Cases reported reduced smell and taste perception as compared to controls. Hyposmia, selective anosmia for a single or few odors, and selective ageusia were more common among cases. These individuals were less capable of identifying specific odors and found them less pleasant than controls.

Mean body weight was not different between cases and controls. In contrast, increased fat mass, lower exercise capacity, lower ‘good’ cholesterol, and higher ‘bad’ cholesterol were related to more severe prior infection. These are known risk factors for severe COVID-19; therefore, the directionality of this association is unknown.

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