Published: 24 October 2023
A major study funded by NIHR has found that tens of thousands of people in England may have lasting symptoms from COVID-19 more than a year after infection.
The REal- time Assessment of Community Transmission (REACT) study, led by researchers at Imperial College London, surveyed a representative sample of more than a quarter of a million people in England. The participants self-reported their symptoms and the impact of COVID-19 on their health and quality of life.
They found that while most people recovered from infection within two weeks, a significant proportion of the group (7.5%) reported persistent symptoms lasting 12 weeks or more (Long COVID). Whilst 5% reported symptoms lasting more than a year.
The findings are published in Nature Communications.
The REACT study was funded by the NIHR and UK Research and Innovation (UKRI). It also had support from the NIHR Imperial Biomedical Research Centre (BRC).
Long COVID
The most common lasting symptoms included mild fatigue, difficulty thinking or concentrating (sometimes called ‘brain fog’) and joint pains.
Other persistent symptoms reported were loss or change of smell and taste, shortness of breath, and severe fatigue. As well as chest tightness or pain and poor memory.
People were more likely to report symptoms for a long time after their initial infection if they were:
- female
- had severe initial symptoms
- were infected earlier in the pandemic
- had pre-existing health conditions
Some of these symptoms were also often reported by people who did not have COVID-19 previously.
The research also found that mental health and health-related quality of life were worse among those with Long COVID.
According to the researchers, the analysis provides a snapshot of the continued impact of COVID-19 in the UK.
They highlight that while SARS-CoV-2 infections are usually short, a large amount of adults will continue to experience long COVID that in some cases may last for over a year or more. However, the researchers note that a sizeable proportion still fully recover after a prolonged period.
Lasting symptoms
In the latest analysis, the team collected follow-up survey responses from 276,840 adults in England. Of these, 59% reported testing positive for COVID-19 between 2020 and 2022.
Analysis shows that on average, symptoms lasted for around 10 days. Yet 1 in 10 people in the study reported symptoms for more than 4 weeks. 1 in 13 had symptoms for more than 12 weeks and 1 in 20 for more than a year.
They found that almost a third of people reporting symptoms at 12 weeks will have recovered within a year.
Among those whose lasting symptoms had fully resolved, people reported health status similar to those with shorter recovery or who had never had COVID-19.
According to the researchers, the analysis also shows that people infected in the Omicron wave (December 2021 onwards) of the pandemic were 88% less likely to experience symptoms longer than 4 weeks post-infection, compared to earlier waves.
Professor Paul Elliott, Chair in Epidemiology and Public Health Medicine from the School of Public Health at Imperial College London, said: “Our latest findings from the REACT study offer further insights into the underlying factors which are associated with prolonged symptoms after initial COVID-19.
"We find that the variant of SARS-CoV-2 people are infected with, the initial severity of their symptoms, and whether they have pre-existing health conditions all have an impact on whether they will develop lasting symptoms.”
Professor Helen Ward, from the School of Public Health at Imperial College London, said: “The study has shown some big variation in people’s symptoms post-COVID. While we have gained valuable insights into the groups at risk of lasting symptoms, we are undertaking detailed interviews to further understand the variation in people’s experiences and the impact on their everyday lives.
"We are also planning further follow-up of people involved in the REACT studies to assess the broader longer-term impact of the pandemic on health and well-being.”