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REACT study lays bare the scale of the UK’s Long COVID problem

15 % of those who had COVID-19 had three or more symptoms of COVID longer than 12 weeks.

In a large scale random community sample of over half a million people, undertaken by several bodies, to include the School of Public Health, Imperial College London and the National Institute for Health Research, the scale of the pandemic’s longer term impact on the nation’s health is set out.

The findings

The findings can be summarised as follows;

  • 508,000 people were asked about any prior history of COVID and the presence/duration of any one of a long list of 29 separate symptoms.
  • Of the sample, the number of people who “self-reported” suffering from COVID-19, was nearly 20 % (19.2 %).
  • Of those self- reporting COVID-19, (76,155 people) over 1/3rd (38 %) had experienced at least one symptom on the check list more than 12 weeks after diagnosis.
  • 15 % of those who had COVID-19 had three or more symptoms of COVID longer than 12 weeks.

This in turn led to the conclusion that 5.75 % of the UK adult population had at least one symptom more than 12 weeks after diagnosis. This prompted the headlines across several media outlets “Two million of the UK adult population suffering from Long COVID”.

Risk factors for Long COVID /severe symptoms

  • The risk of persistent symptoms increased by age.
  • Persistent symptoms were 1.5 times more likely to appear in women than men.
  • Other risk factors included obesity, smoking/vaping, hospitalisation and deprivation.
  • Conversely, those of Asian ethnicity were said to be at lower risk of developing enduring symptoms.

Grouping of symptoms and recovery

Researchers found these broadly fell into two “stable clusters” or categories:

  1. ‘Fatigue’, to include muscle aches, difficulty sleeping and shortness of breath.
  2. ‘Respiratory’, to include chest pain.

The majority fell in to the respiratory group rather than fatigue. Whilst some patients reported an improvement in symptoms between 4 and 12 weeks after diagnosis, any improvement in symptoms largely tailed off after 12 weeks.

Relevance and implications

Both the volume of participants and the control measures exercised by the researchers will make it difficult for the study to be regarded as unrepresentative or to be ignored.

Whilst there is no settled definition of “Long COVID”, at its loosest, Long COVID appears to impact a significant number – estimated to be 2 million of the UK adult population.

This, combined with worrying evidence that recovery plateaus 12 weeks after diagnosis, drives the conclusion that significant numbers will require longer treatment and care, with financial and resource implications for the NHS and health care providers.

The study also reinforces how COVID-19, in common with so many other diseases, disproportionately impacts upon the socially and economically deprived - both in terms of the likelihood of contracting COVID and in terms of symptom prevalence.

COVID-19 will cause the divisions already seen in health outcomes according to social and economic status to grow rather than recede over the coming years.

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