New survey data from the landmark Women's Health Initiative (WHI) reveal that 34% of postmenopausal women infected with COVID-19 had symptoms lasting at least 8 weeks, while a separate 2-year telemedicine study shows that 84% and 61% of all infected patients still had symptoms 1 and 2 years later, respectively.
Fatigue, malaise, brain fog common
For the WHI study, a Fred Hutchinson Cancer Center–led research team surveyed 37,280 women aged 50 to 79 years at 40 US clinical centers about long-COVID symptoms and their duration from August to December 2021. They used machine learning and logistic regression models to gauge the strength of symptoms' association with long COVID. The results were published today in the Annals of Epidemiology.
"Long-term health, psychosocial and demographic data are needed to fully understand long COVID risk factors in the elderly and to design and implement effective prevention," the study authors wrote.
Of 37,280 survey respondents, 3.3% reported testing positive for COVID-19 (average age, 84 years), and 34% said they still had neurologic, cardiopulmonary, musculoskeletal symptoms, as well as fatigue and malaise. Nearly all respondents (91%) were White, and no differences between race and long-COVID status were observed.
As new variants continue to emerge and infect people, older adults remain highly vulnerable to long-term health effects from this pathogen.
Common symptoms lasting longer than 8 weeks were fatigue (51.8%), general malaise (34.6%), memory problems (34.4%), and brain fog (31.8%). Over 20% of long-COVID patients reported memory problems and fatigue for more than 6 months.
Risk factors for long COVID were a weight loss of 10 pounds or more in the previous 2 years, sleep problems, limited physical and mobility, previous heart-valve procedures, and rheumatoid arthritis. Physical-function risk factors for long COVID were a limited ability to bend, kneel, stoop, or grocery shop, as well as the use of a wheelchair, walker, or crutches on level surfaces. Lower odds of long COVID were tied to older age and the use of calcium supplements.
"As new variants continue to emerge and infect people, older adults remain highly vulnerable to long-term health effects from this pathogen," the researchers concluded. "Continued multidisciplinary research is needed to understand and prevent long COVID to reduce morbidity and mortality and maintain quality of life in older adults."
Long COVID fell from 84% to 61% from year 1 to year 2
For the second study, published in PLOS One, a team led by University of Milan researchers in Italy conducted 2-year semi-structured interviews with 165 COVID-19 patients who had been monitored by a telemedicine operations center from February to May 2020. Median patient age was 53 years, 53% were women, 28% had high blood pressure, 9.1% had cardiovascular disease, and 7.9% had diabetes.
The potential value of telemedicine platforms is evident in pandemic situations and other conditions where isolation is essential,
Of the 165 patients, 84% reported lingering symptoms 1 year after infection, while 61% still had them at 2 years. About half (49%) of participants who had long-COVID symptoms at 2 years had reported them at 1 year, had received the COVID-19 vaccine, and hadn't been reinfected in the interval. Having long COVID at 1 year postinfection and getting reinfected were significant risk factors for persistent symptoms at 2 years. Vaccination wasn't observed to be a protective factor, which the researchers attributed to the small number of unvaccinated participants.
"The potential value of telemedicine platforms is evident in pandemic situations and other conditions where isolation is essential," the authors wrote. "The sample size of our study is small, necessitating further research on a wider cohort with longer follow-ups. While telemedicine has some barriers, such as accessibility, maintenance costs and insufficient legal regulations, these obstacles are surmountable given its usefulness in monitoring many clinical conditions."
