A new Canadian study found that a quarter of people with prolonged COVID still experience at least one symptom a year later.
It found that the majority of those battling prolonged COVID had recovered within 12 months, regardless of how severe their symptoms were, giving some hope for recovery rates.
But those with persistent symptoms were more likely to have higher levels of an autoimmune disease marker, suggesting that lingering symptoms may need more attention to recover.
“In general, one should not worry if they feel unwell immediately after infection, as the chances of recovery within 12 months are very high, and just because you have the typical long symptoms of COVID at three months does not mean that they will remain forever,” Manali Mukherjee, assistant professor of medicine at McMaster University and senior author of the study, said in a news release.
“However, the study highlights that after 12 months, if you are still feeling unwell and symptoms persist or worsen, you should definitely seek medical attention.”
Long COVID is the term for those dealing with a diverse array of persistent symptoms for more than 12 weeks after recovering from a COVID-19 infection, ranging from crippling fatigue to muscle aches to neurological problems. According to the World Health Organization, between 10 and 20 percent of those infected with COVID-19 experience some form of prolonged COVID.
For this study, published in the peer-reviewed European Respiratory Journal, researchers from McMaster and the University of British Columbia focused on three of the most common symptoms: fatigue, cough and shortness of breath.
To study the recovery process, the researchers followed 106 people who were in the process of recovering from COVID-19 infections, checking in at three, six and 12 months after the patients contracted the virus. The patients were otherwise healthy, with no previous illnesses.
The researchers wanted to see whether a specific type of antibody, which is produced when a person’s immune system incorrectly attacks itself, was present in those recovering from COVID-19, and whether these antinuclear antibodies (ANAs) – which are associated with autoimmune diseases – are associated with the development of prolonged COVID in patients.
They found that compared to an age- and sex-matched control group, those with COVID-19 had more ANA in their bodies three months after recovery.
ANA counts decreased over time between three and 12 months among COVID-19 patients overall. But those who still report constant fatigue, a severe cough or shortness of breath are more likely to have higher levels of ANAs still in them.
Mukherjee said in the release that those struggling with prolonged COVID lasting a year or more should see a rheumatologist because of their experience with autoimmune diseases. Currently, because of the lack of knowledge surrounding long-term COVID, many patients are likely to seek help only from respirologists or infectious disease specialists, she said, but the problem may need more specialized help if it persists.
“Sometimes, while the body is fighting the virus, the immune system is boosted to such an extent that in addition to producing antibodies that kill the virus, it can produce antibodies that attack the host,” Mukherjee said.
“However, the body’s general tendency after fighting a severe virus like SARS-CoV-2 is to recover, and it is often delayed, varying from individual to individual.”
The fact that the continued presence of high ANA levels in patients at month 12 was associated with persistent symptoms and inflammation suggests that the role of autoimmunity in prolonged COVID needs more attention, the study said.
To study it further, Mukherjee is leading the upcoming “Autoimmunity in Post-Acute COVID Syndrome” study, which is funded by the federal government. This study is currently recruiting participants, as is the Canadian Respiratory Research Network Long COVID study.
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