SARS-CoV-2 variants and Long COVID syndrome

This article shows that Long COVID symptoms resulting from different variants can vary. And that some variants tend to cause more Long COVID syndromes.

According to the World Health Organization, Long COVID syndrome occurs in individuals with probable or confirmed SARS-CoV-2 infection history. It usually starts three months from the onset of COVID-19, and the symptoms last for at least two months and cannot be explained by an alternative diagnosis.[1]

Symptoms may be new following initial recovery from an acute COVID19 or persist from the initial illness. The symptoms may fluctuate or go away but return over time.

Common symptoms include fatigue, shortness of breath, and cognitive dysfunction, which generally impact everyday functioning. The other symptoms, according to the WHO Delphi consensus in October 2021, are:

Abdominal pain
Menstrual and period problems
Altered smell/taste
Anxiety
Blurred vision
Chest pain
Cognitive dysfunction/brain fog
Cough
Depression
Dizziness
Fatigue
Intermittent fever
Gastrointestinal issues (diarrhea, constipation, acid reflux)
Headache
Memory issues
Joint pain
Muscle pain/spasms
Neuralgias
New onset allergies
Pins and needles sensations
Post-exertional malaise
Shortness of breath
Sleep disorders
Rapid heart rate/palpitations
Ringing in the ears and other hearing issues

Long COVID is also known as Long-haul COVID, COVID-long, post-acute sequelae of COVID-19 (PASC), post-COVID, and COVID syndrome.

Long COVID may last for months or years.

According to the CDC, anyone with COVID-19 may have Long COVID regardless of severity.

Post-COVID conditions are found more often in people who had severe COVID-19 illness, but anyone who has been infected with the virus that causes COVID-19 can experience post-COVID conditions, even people who had mild illness or no symptoms from COVID-19.

Long COVID studies

An early study among 250 000 COVID-19 survivors showed more than half experienced Long COVID symptoms six months after recovery.[2]

Spinicci and colleagues from the University of Florence and Careggi University Hospital in Italy made an observational study on 428 patients. 59% were men, and 41% were women[3]

All were treated from June 2020 to June 2021. At that time, the original form of SARS-CoV-2 and the Alpha variant were circulating in the population.

All the patients were hospitalized and followed after their discharge. (76%) of patients reported at least one persistent symptom. The most common reported symptoms were:

Shortness of breath (37%)
Chronic fatigue (36%)
Sleep problems (16%)
Visual problems (13%)
Brain fog (13%).

People with more severe forms were six times as likely to report long COVID symptoms. Examples are those who required immunosuppressant drugs such as tocilizumab.

Those who received high flow oxygen support were 40% more likely to experience Long COVID. High-flow oxygen can deliver up to 60 Liters/minute, whereas a typical nasal cannula delivers only up to 6 L/min.

Women were almost twice as likely to report symptoms of long COVID compared with men. Interestingly, patients with type 2 diabetes seemed to have a lower risk of developing long COVID symptoms.

Symptoms depend on infecting SARS-CoV-2 variants

When the Alpha variant was the dominant strain, the Long COVID syndromes showed a higher prevalence of muscle aches and pain, insomnia, brain fog, and anxiety/depression compared to those infected with the original variant.

(Note that this study was done relatively early in the pandemic and does not include the Delta and Omicron variants. The other thing is I cannot find the study or abstract on NCBI. That is why I had to rely on other articles about it. Thus it looks incomplete. If you find it, please send me a link.)

Some variants cause more Long-COVID

Another study involved 56 003 UK adults who tested positive for SARS-CoV-2 when the Omicron variant was 70% predominant and another 41 361 UK adults when the Delta variant was dominant.

This time the study included both asymptomatic and asymptomatic COVID-19.

Among omicron cases, 4·5% experienced long COVID. Among the delta cases, 10·8% developed Long COVID.

However, the Omicron variant is more infectious than the Delta and the other variants. This is why in the end, more people who had the Omicron COVID-19 will have the Long COVID syndrome.

COVID-19 shots and Long-COVID syndrome

There are many reports of people who suffered Long COVID after getting the shots. The US National Institute of Health started to get data from people with Post Vaccine COVID syndrome.

However, the NIH dropped the study for some unexplained reason. We can guess why. (Cough. Big pharma pressure. Cough, cough). The story is at: In rare cases, coronavirus vaccines may cause Long Covid–like symptoms from Science.

How to prevent Long COVID

Long COVID results from the persistence of the spike protein in the body. If no treatment is given early in the disease, the SARS-CoV-2 continues to multiply, and the body develops autoimmune antibodies. The autoimmunity that results can explain the symptoms of Long COVID.

Early treatment prevents not only Long COVID but also averts viral replication, the emergence of more variants, COVID-19 hospitalization, and deaths.

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References:

A clinical case definition of the post-COVID-19 condition by a Delphi consensus, October 6, 2021
Groff D et al. Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review. JAMA Netw Open. 2021;4(10):e2128568. doi:10.1001/jamanetworkopen.2021.28568
Different SARS-CoV-2 variants may give rise to different long COVID symptoms – European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Lisbon, Portugal (23-26 April)
Antonelli M, Pujol JC, Spector TD, Ourselin S, Steves CJ. Risk of long COVID associated with Delta versus omicron variants of SARS-CoV-2. Lancet. 2022 June 18;399(10343):2263-2264. doi: 10.1016/S0140-6736(22)00941-2. PMID: 35717982; PMCID: PMC9212672.

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