📣 New paper in @NatureMedicine
Three-year outcomes of post-acute sequelae
of COVID-19
By Miao Cai @Biostayan @EricTopol and me
A 🧵
nature.com/articles/s4159…
In a study of 5.3 million people including 135,161 people with SARS-CoV-2 infection and 5,206,835 non-infected controls.
We examined risk trajectories of 80 components of Long Covid over 3 years post-infection
nature.com/articles/s4159…
The good news: risks of death and post-acute sequelae declined over time in both people who had mild COVID-19 and those with severe COVID-19 that required hospitalization.
nature.com/articles/s4159…
Among people who had mild COVID-19 , risk of death became insignificant 1 year after infection
Risk of new post acute sequelae declined over time, but residual risk remained even at 3 years in the pulmonary, GI and nervous systems.
nature.com/articles/s4159…
This residual risk in the third year translates into 41 new sequelae/Long Covid components per 1000 persons in the third year (4 sequelae per 100 people)
nature.com/articles/s4159…
In hospitalized patients
🚨Risk of death declined over time, but remained elevated even 3 years after infection
🚨Risk of new post acute sequelae declined over time, but significant risk remained even at 3 years in nearly all organ systems - cardiovascular, neurologic, GI, coagulation and pulmonary organ systems
nature.com/articles/s4159…
This risk in the third year translates into 252 new sequelae/Long Covid components per 1000 persons in the third year (~ 25 sequelae per 100 people)
nature.com/articles/s4159…
New conditions in the third year after infection led to
🔸 10 DALYs per 1000 persons in non-hospitalized
🔸 90 DALYs per 1000 persons in those who were hospitalized during acute COVID
One DALY equals one lost year of healthy life
nature.com/articles/s4159…
The big revelation here is that the risk persists for 3 years in several organ systems (e.g. GI and nervous system) even 3 years after a mild infection.
Healthcare professionals are taught that acute infections as short-term events with health effects that manifest around the time of infection.
The data challenges those teachings and shows that mild Covid can still cause health effects even 3 years later.
Acute infections can have long-term health effects.
Covid continues to teach us something new at every turn and this is one very important new lesson.
nature.com/articles/s4159…
Why is this be happening?
Possibly viral persistence (perhaps far more common than most people think), chronic inflammation or chronic immune dysfunction or all the above.
nature.com/articles/s4159…
The story in hospitalized people is more stark – they have greater risk and longer risk horizon with resultant burden of disease that is astronomically much higher than non-infected people and higher than non-hospitalized individuals.
Hospitalization can have huge and wide-ranging effects on people's lives for years if not more. Preventing hospitalization is very important.
nature.com/articles/s4159…
While I talked about hospitalization in the previous tweet, I want to make it clear that most people with Long Covid had mild COVID-19.
In fact, 90% of people with Long Covid had mild
COVID-19.
nature.com/articles/s4159…
Thanks to the amazing @sourwine for developing this press release and @EbetheHolland for editing (link below).
@WUSTLnews
@WUSTLmed
@WUSTL
medicine.wustl.edu/news/covid-can…
Thanks also to our reviewers, editors, and all those who supported us in this project.
And to my wonderful co-authors Miao Cai and @Biostayan
Grateful for the collaboration with @EricTopol
@WUSTLmed @VREFSTL @VAResearch @vahsrd
nature.com/articles/s4159…
Coverage in @FortuneMagazine by @cbarbermd
fortune.com/well/article/c…
Great piece by @jwgale in @business
bloomberg.com/news/articles/…
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