January 27, 2023 — Almost 36% of students and faculty at George Washington University with a history of COVID-19 reported symptoms consistent with chronic COVID in a new study.
With a median age of 23 years, the study is unique for evaluating mostly healthy, young adults and for its rare look at long-term COVID in a university community.
The more symptoms during a bout with COVID, the greater the risk for prolonged COVID, the researchers found. That lines up with previous studies. Also, the more vaccinations and booster shots against SARS-CoV-2, the virus that causes COVID, the lower the long-term COVID risk.
Women were more likely than men to be affected. Current or prior smoking, seeking medical care for COVID, and receiving antibody treatment were also linked to higher chances for developing prolonged COVID.
Lead author Megan Landry, DrPH, MPH, and colleagues were already assessing students, staff, and faculty at George Washington University in Washington, DC, who tested positive for COVID. Then they started seeing symptoms that lasted 28 days or more after their 10-day isolation period.
“We were starting to recognize that individuals … were still having symptoms longer than the typical isolation period,” says Landry. So they developed a questionnaire to figure out how long these symptoms last and how many people are affected by them.
The list of potential symptoms was long and included trouble thinking, fatigue, loss of smell or taste, shortness of breath, and more.
The study was published online Thursday in the CDC’s Emerging Infectious Diseases journal. Results are based on records and responses from 1,388 students, faculty, and staff from July 2021 to March 2022.
People had a median of four long-term COVID symptoms, about 63% were women, and 56% were non-Hispanic white. About three-quarters were students and the remainder were faculty and staff.
The finding that 36% of people with a history of COVID reported long COVID symptoms did not surprise Landry.
“Based on the literature that’s currently out there, it ranges from a 10% to an 80% prevalence of chronic COVID,” she says. “We kind of figured that we would fall somewhere in there.”
In contrast, that figure seemed high to Eric Topol, MD, editor-in-chief ofMedscape, WebMD’s sister site for health care professionals.
“That’s really high,” says Topol, who is also founder and director of the Scripps Research Translational Institute in La Jolla, CA. Topol says most studies estimate that about 10% of people with a history of acute infection develop long-term COVID.
Even at 10%, which could be an underestimate, that’s a lot of affected people globally.
“At least 65 million individuals around the world have chronic COVID, based on a conservative estimated incidence of 10% of infected people and more than 651 million documented COVID-19 cases worldwide; the number is likely much higher due to many undocumented cases,” Topol and colleagues write in a long COVID review article published earlier this month in Nature Reviews Microbiology.
Topol agrees the study is unique in evaluating younger adults. Long COVID is much more common in middle-aged people, those in their 30s and 40s, rather than students, he says.
About 30% of study participants were fully vaccinated with an initial vaccine series, 42% had received a booster dose, and 29% were not fully vaccinated at the time of their first positive test for COVID. Those who were not fully vaccinated were significantly more likely to report symptoms of chronic COVID.
“I know a lot of people wish they could put COVID on the back burner or brush it under the rug, but COVID is still a real thing. We need to continue supporting vaccines and boosters and make sure people are up to date. Not only for COVID, but for flu as well.”
“Long COVID is still evolving and we continue to learn more about it every day,” Landry says. “It’s just so new and there are still a lot of unknowns. That’s why it’s important to get this information out.”
People with long COVID often have a hard time with occupational, educational, social, or personal activities compared to before COVID, with effects that can last for more than 6 months, the authors note.
“I think across the board, universities in general need to consider the possibility of people on their campuses are having symptoms of chronic COVID,” Landry says.
Moving forward, Landry and colleagues would like to continue investigating long COVID. For example, in the current study, they did not ask about severity of symptoms or how the symptoms affected daily functioning.
“I would like to continue this and dive deeper into how disruptive their symptoms of long COVID are to their everyday studying, teaching, or their activities to keep a university running,” Landry says.