‘Issue of inequalities’ for long COVID patients needs to be addressed

The “big issue of inequalities” for long COVID patients who face ongoing symptoms and disability needs to be addressed, an expert has said.

Long COVID is a condition where people experience persistent or new symptoms following an episode of COVID-19. These include fatigue and shortness of breath and can last for weeks or months after the initial infection.

Professor Helen Ward, from Imperial College London’s School of Public Health, is leading a study into long COVID to better understand why some people have persistent symptoms after being infected with the coronavirus.

It is hoped that the research, which involves more than 120,000 participants, will help to find ways of diagnosing, supporting and treating people who have the condition. 

Survey data published in June 2021 from the Imperial-led REACT-2 study suggested that more than two million people in England may have been affected by persistent symptoms of COVID-19 at some point during the pandemic.

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Professor Ward told an Imperial College Academic Health Science Centre (AHSC) online seminar earlier this month that her study was investigating the symptom profiles and prevalence of long COVID, as well as biological factors that may put people at risk of the condition. 

She was joined by Professor Danny Altmann, of Imperial’s Department of Immunology and Inflammation, who spoke about his work on researching antiviral immunity and patterns of autoimmune antibodies in people with long COVID compared to those who have recovered from the virus.

Surveillance urgently needed

Professor Ward identified a number of challenges with researching long COVID, such as how to accurately define the condition and how to get a sense of the scale of the problem. 

She said: “We really need surveillance of long COVID. Up to now the burden of SARS-CoV-2 has mainly been measured by the numbers of cases diagnosed and mortality from COVID-19, with an implicit assumption that you either die or get better. We also need to measure long-term health impacts.

“We are starting to see that there is a substantial burden of disability and prolonged symptoms. 

“It’s not something that we have got a global handle on so far, but in many studies it’s between 10 and 30 per cent of people who have these persistent and late symptoms, some of which are really debilitating.” 

She continued: “There is a big issue of inequalities here because we know that Sars-CoV-2 has been particularly prevalent in people who are more deprived, and has more severe impacts on people who have other conditions and illnesses. These groups have been more affected by COVID, and as we can see also by long COVID.” 

Professor Ward emphasised that it was important for long COVID patients to be involved in shaping such research, as the findings could help to improve treatments and services, but also access to benefits and occupational health support for those who have the condition. 

During the talk, Professor Ward also outlined the preliminary findings from the REACT study that suggest people who come from lower income households and areas of high deprivation are more likely to have persistent symptoms from the virus. 

Other factors linked to a higher risk of persistent symptoms include older age, high body mass index (BMI), smoking, and female sex.