January 11, 2023

expert reaction to study looking at long covid outcomes at one year after mild Covid infection

A study published in the BMJ, looks at long covid outcomes at one year after mild SARS-CoV-2 infection in Israel.

Prof Peter Openshaw, Professor of Experimental Medicine, Imperial College London, said:

“This is a large and interesting study looking at the aftermath of COVID (post-COVID syndrome or Long COVID) in Israel, at a time when Alpha and Delta variants were circulating.

“Because of the study’s size, it was possible to look at the change in symptom prevalence over time and the effects of other factors on persistent symptoms.  Persistent shortness of breath tended to resolve over time and vaccination was associated with lower risk of developing it.  Women tended to report hair loss which was also prevented by vaccination, peaked at 4-5 months and resolved after 6 months.  Smell disorder typically resolved at about 9 months, but when they were present concentration and memory changes tended to be more persistent.

“The general message that symptoms improve over time is encouraging, but it may take a year or so for some symptoms to resolve.  The study adds to the evidence that outcomes are improved by vaccination, even if vaccines don’t prevent viral transmission very well.”

Dr Michael Absoud, Honorary Reader, Department of Women & Children’s Health, King’s College London, said:

“This is a reassuring large population medical record study from Israel, which also included children of all ages during the periods when the original SARS-CoV-2 strain, alpha and then Delta were dominant.  It confirms that in children, of the small proportion who have prolonged persistent symptoms post SARS-CoV-2 infection, the vast majority show a very good recovery.  Furthermore, we are in a very different situation than even one year ago after Omicron and its subvariants emerged, with very high levels of population immunity.  However, whereas mercifully, the child population is resilient to SARS-CoV-2, it has not been resilient to the long-term impacts of pandemic policies (including reduced in-person services such as health visiting, therapies, dental care, and safeguarding services).

“On the ground, The UK Post-Covid clinics in England, have demonstrated the value of integrating multi-disciplinary mental and physical health services.  This could hence be an opportunity to narrow child health inequalities impacted by COVID policies, by expanding this model of care in child health services.  A shift in focus of what mitigating against childhood illness entails is needed, amidst a cost of living crisis which is impacting children disproportionately.”

‘Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study’ by Barak Mizrahi et al. was published in the BMJ at 23:30 UK time on Wednesday 11 January 2023.

DOI: 10.1136/bmj‑2022‑072529

Declared interests

Prof Peter Openshaw: “I have been on scientific advisory panels for GSK, Moderna, Janssen, Seqirus and Pfizer on vaccines against respiratory viral infections.”

Dr Michael Absoud: “No conflicts of interest.”