London, Jul 15: Patients who experience long Covid can report more than 200 symptoms across 10 organ systems, according to a study published in the Lancet’s journal EClinicalMedicine on Thursday.
The study, led by University College London (UCL) scientists together with a patient-led research collaborative, found the most common symptoms of long-term COVID effects as fatigue, post-exertional malaise (the worsening of symptoms after physical or mental exertion), and cognitive dysfunction, often called brain fog.
Of the diverse range of symptoms, others included: visual hallucinations, tremors, itchy skin, changes to the menstrual cycle, sexual dysfunction, heart palpitations, bladder control issues, shingles, memory loss, blurred vision, diarrhoea, and tinnitus.
While there has been a lot of public discussion around long COVID, there are few systematic studies investigating this population; hence relatively little is known about its range of symptoms, and their progression over time, the severity, and expected clinical course (longevity), its impact on daily functioning, and expected return to baseline health, said Dr Athena Akrami, neuroscientist at the Sainsbury Wellcome Centre at UCL and senior of the study published in the Lancet's EClinicalMedicine'.
In this unique approach, we have gone directly to long haulers' around the world in order to establish a foundation of evidence for medical investigation, improvement of care, and advocacy for the long COVID population. This is the most comprehensive characterisation of long COVID symptoms, so far, she said.
For the study, patient researchers connected through the Body Politic online COVID-19 support group and created a web-based survey designed to characterise the symptom profile and time course in patients with confirmed or suspected long COVID, along with the impact on daily life, work, and return to health.
With responses from 3,762 eligible participants from 56 countries, the researchers identified a total of 203 symptoms in 10 organ systems; of these, 66 symptoms were tracked for seven months.
The research team, who have all had or continue to have long COVID, are now calling for clinical guidelines on assessing long COVID to be significantly widened beyond currently advised cardiovascular and respiratory function tests to include neuropsychiatric, neurological, and activity intolerance symptoms.
The authors also advocate that a national screening programme, accessible to anyone who thinks they have long COVID, should be undertaken.
Given the heterogeneous and diverse make-up of symptoms that affect multiple organ systems, it is only by detecting the root cause that patients will receive the correct treatment, they note.
Dr Akrami added: For the first time this study shines a light on the vast spectrum of symptoms, particularly neurological, prevalent and persistent in patients with long COVID.
Memory and cognitive dysfunction, experienced by over 85 per cent of respondents, were the most pervasive and persisting neurologic symptoms, equally common across all ages, and with substantial impact on work. Headaches, insomnia, vertigo, neuralgia, neuropsychiatric changes, tremors, sensitivity to noise and light, hallucinations (olfactory and other), tinnitus, and other sensorimotor symptoms were also all common, and may point to larger neurological issues involving both the central and peripheral nervous system.
The survey was open to those aged 18 or over who had experienced symptoms consistent with COVID-19, including those with and without a positive SARS-CoV-2 test. It consisted of 257 questions.
In order to characterise long COVID symptoms over an extended duration, analysis of survey data was limited to respondents with illnesses lasting longer than 28 days and whose onset of symptoms occurred between December 2019 and May 2020, allowing analysis of symptoms from week one to month seven.
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Tokyo, Jul 31: Indian women's hockey team qualified for the Olympic quarterfinals after 41 years after it beat South Africa 4-3 and later defending champions Great Britain blanked Ireland 2-0 to ensure its passage into the knockout stage, here on Saturday.
India finished their group A league proceedings in fourth place with six points, riding on back-to-back wins over Ireland and South Africa and will now face pool B toppers Australia in the quarter-final on Monday.
The top four teams from each pool made it to the knockout stage.
Indian women team's best finish at the Olympics was in Moscow back in 1980 when they reached the semi-finals but ended fourth.
While Great Britain's win was required, no one can take away credit from Vandana Kataria, who scored a hat-trick in India's win in a pulsating morning clash against the South Africans.
Kataria (4th, 17th, 49th minutes) achieved a rare feat by becoming the first Indian woman hockey player to score a hat-trick in the Olympics.
Young Neha Goyal (32nd) was the other goal getter.
South Africa's goals came from the sticks of Tarryn Glasby (15th), skipper Erin Hunter (30th) and Marizen Marais (39th).
"Today's game was really tough, South Africa gave us a really good fight. They converted their chances in the circle. Defensively, we can be a lot better," skipper Rani said.
India's chief coach Sjoerd Marijne heaved a sigh of relief but was not happy with the number of goals his side conceded.
"We gave too many goals away, and I think we can score more goals, that is the main thing for today. We did what we had to do, we had to win this match, and we did," he said.
"Playing in these circumstances, you feel it, the humidity and I think it's more than 35 degrees on the pitch, it does not make it easy, he added.
Needing a win to stay alive in the competition, the Indians meant business and pressed hard on the South African defence from the start.
In doing so, India secured two penalty corners in the first two minutes of the match but drag-flicker Gurjit Kaur's poor execution continued in the tournament.
Still, it didn't take India long to open their account and in the fourth minute, Kataria gave her side the lead, tapping in from close range after being set up by Navneet Kaur's great run from the right flank.
India kept up the pressure and penetrated the South African circle many times without much success.
But seconds from the end of first quarter, a lapse in concentration from the defence cost India dearly as South Africa drew level through Tarryn Glasby, who deflected in a long shot from Taryn Mallett.
India had enough time to regain their lead through a penalty corner but wasted the opportunity.
Two minutes into the second quarter, Kataria restored India's lead when he deflected in Deep Grace Ekka's flick from their fourth penalty corner.
The Indians had three more chances to extend their lead in the second quarter but they couldn't do so.
The Rani Rampal-led side got two more penalty corners which they wasted, and then, Goyal's effort from open play was saved by the South Africa goalkeeper.
Just like in the first quarter, India gave away their lead seconds away from half time when Hunter found the net from her team's first penalty corner.
Two minutes after the change of ends, Goyal restored the lead again, deflecting in a Rani hit from a penalty corner as the Indians executed a fine variation.
The fragile Indian defence wilted under pressure once again, when South Africa drew level for the third time in the match, through a Marais strike.
South Africa enjoyed a good run of play in the initial minutes of final quarter and, in the process, secured three penalty corners quickly, but this time the Indian defence did enough to thwart the danger.
In the 49th minute, a brilliant Kataria saved the day for India when she deflected in Gurjit Kaur's flick from another penalty corner.
Thereafter, the Indians fell back and looked content to keep the possession as South Africa pressed hard.
Two minutes from the final hooter, the Indians successfully referred a penalty corner decision given against them.
"It is about consistency. Yesterday (Friday), we played a really good match. And now we have a back to back and your legs are heavier, things are not going as smoothly. So these things you just know. You saw our basics were not as good as yesterday, it is all about that," Marijne said.
"It is important to play matches. I am not someone, I hope you see that, who ever finds excuses, but we just have not done it. I don't blame anyone, it is just the way it is."
Marijne feels the knockout stage would be different ball game from the group stage.
"The tournament starts again. If you play well, or not well in the pool matches it does not matter, it starts all over.
"It will be another type of game because it is high pressure, everything or nothing. The good thing is we had that in the last two matches, so we have already experienced that."