Scientists have developed a scale of symptoms of post-COVID syndrome

American scientists analyzed the data of almost 10 thousand people with and without coronavirus infection and developed a scale of 12 symptoms to identify post-COVID syndrome. Among them are malaise, fatigue, chronic cough, changes in sexual desire. Scientists were able to identify long-covid in 10% of study participants. The National Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation noted that such scales should include not only the analysis of symptoms, but also their relationship with age, gender, race, and region of residence. Similar studies are also underway in Russia, but their generalized data are not yet available. Unequivocally, Russian scientists point out the worsening of the course of chronic non-communicable diseases, especially arterial hypertension and diabetes, as a manifestation of post-COVID.

The results of a study by scientists from Harvard Medical School, Stanford University School of Medicine and New York University Grossman School of Medicine concerning post-COVID syndrome appeared in the JAMA Network journal of the American Medical Association. The researchers analyzed data from 9,764 people with and without coronavirus infection six months or more after infection or testing. Initially, the scientists looked at 44 symptoms reported by patients, but ultimately proposed a scale for long-COVID based on the 12 most common. These include post-exercise malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sex drive, loss or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements (eg, tremors). The severity of each symptom was assessed on a scale from 1 to 8 points, and the threshold value for the establishment of post-COVID syndrome was 12 points in total.

Using the scale, scientists were able to identify post-COVID syndrome in 10% of study participants infected with the omicron variant of the coronavirus. In fully vaccinated patients, the frequency of symptoms was lower than in unvaccinated patients. The importance of the work, according to its authors, lies in the fact that, unlike electronic health records and most existing cohort studies, the data of this analysis covered symptoms “specific for the post-acute consequences of SARS-CoV-2 infection”, which were reported by patients , “based on standardized questionnaires developed with their own participation.” The authors believe that further studies will be required to clarify the criteria for post-COVID syndrome.

Oksana Drapkina, chief non-staff specialist in therapy and general medical practice of the Ministry of Health of the Russian Federation, commenting on the findings of the study, speaks of certain limitations, which in the near future, most likely, will not allow the use of the proposed scale as a diagnostic tool in wide practice. She calls the weakening of the discriminant characteristics of the threshold scores of the developed scale due to the neglect of asymptomatic infections caused by SARS-CoV-2 being the most important limitations; the underestimation of the importance of vaccination status and the fact that more than 200 symptoms have been reported in total, each of which has the potential to change the health status and quality of life of a patient after COVID-19. “We believe that such scales should include not only the analysis of symptoms, but also their relationship with age, gender, race, region of residence, social determinants of health, risk factors, existing comorbidities, vaccination status, and so on,” says Oksana Drapkin.

Russia adheres to the definition of post-COVID syndrome as a condition that usually occurs three months after the onset of COVID-19, with symptoms that last at least two months and cannot be explained by an alternative diagnosis, Ms. Drapkina points out. These are post-covid exacerbations of chronic diseases; the transition of pre-morbid conditions (preceding and contributing to the development of the disease) into the clinical manifestation of a new disease that the patient did not have before; the appearance of previously non-existing symptoms. “Over the past two years, representatives of a number of medical communities in our country have demonstrated the results of registries of patients who have suffered COVID-19. To date, there are no generalized data summarizing the results of such studies. But in general, decompensation is clearly noted (manifestation, exacerbation of development.— “b”) chronic non-communicable diseases, especially arterial hypertension and diabetes,” emphasizes Oksana Drapkina.

According to her, employees of the National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of Russia continue to analyze the features of the immune status and outcomes in people vaccinated against the SARS-CoV-2 virus (a sample of 4 thousand people), as well as in patients who underwent COVID-19 (775 people). In addition, as part of the Persona study (personalized rehabilitation of patients who have had a coronavirus infection), about 250 patients were examined and rehabilitated. Most often, they had destabilization of blood pressure (50%), shortness of breath (45%), palpitations or interruptions in the work of the heart (25%), fatigue (15%), memory impairment (10%). Less commonly, researchers recorded abdominal pain (2.1%), changes in smell and taste (3.7%), chest pain (6.2%), dizziness (5.2%), joint pain (2.0% ).

Olga Shuppo, scientific director of the Grand Clinic network of immunorehabilitation and preventive medicine clinics, says that private medicine also deals with manifestations of long-covid. According to her, after about six months, patients who have been ill with coronavirus return with complaints of a number of ailments that they did not encounter before the disease. Their list coincides with those listed in the American study. On top of that, she adds, patients in the network of clinics especially often complain about depression, depression and decreased motivation after the coronavirus: “Some have psychiatric problems in addition to depression. In this regard, it is extremely important to undergo a course of rehabilitation so that the body fully recovers from the virus.”

Natalia Kostarnova