Lingering Cold and Respiratory Virus Symptoms: A Hidden Epidemic?

Lingering Cold and Respiratory Virus Symptoms

New research published in The Lancet’s EClinicalMedicine suggests that individuals who experience acute respiratory infections but test negative for COVID-19 may also suffer from persistent symptoms similar to those seen in long COVID cases. These prolonged symptoms are sometimes referred to as “long colds” and appear to have a comparable impact to long COVID.

Adrian Martineau, the chief investigator of COVIDENCE UK and a clinical professor of Respiratory Infection and Immunity at Queen Mary University of London, commented on the findings. He noted that these results may resonate with individuals who have endured extended symptoms following respiratory infections, despite testing negative for COVID-19.

The study aims to shed light on why some people experience prolonged symptoms after respiratory infections and may help identify appropriate treatments and care for affected individuals.

Understanding the long-term effects of COVID-19 and other acute respiratory infections is crucial as it can provide insights into why some individuals experience persistent symptoms while others do not. This knowledge may ultimately lead to the development of more appropriate treatment and care for those affected.

The study involved a comparison of the severity and prevalence of long-term symptoms in individuals who had recovered from COVID-19 and those who had experienced other acute respiratory infections but tested negative for the virus. Data was collected from the COVIDENCE UK study, which began in 2020 and included over 19,000 participants. The analysis focused on data from more than 10,000 adults.

Quality of Life and ‘Long Colds’

The study included 1,311 individuals who had contracted COVID-19 and 472 who had experienced a non-COVID acute respiratory infection.

The research findings revealed that both types of illnesses were linked to a range of persistent symptoms and a decline in the quality of life related to health.

Individuals who had recovered from COVID-19 were more likely to report issues with their sense of taste and smell, as well as symptoms like light-headedness and dizziness.

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On the other hand, those with lingering symptoms after a non-COVID acute respiratory infection reported a variety of issues, including coughing, abdominal pain, and diarrhea.

The severity of these persistent symptoms, whether from COVID-19 or non-COVID respiratory infections, was connected to the initial infection’s severity.

The study also highlighted that individuals who experienced more severe symptoms were often female, frontline workers, overweight, socioeconomically disadvantaged, or had pre-existing medical conditions.

Unknown Long-term Health Effects

The researchers point out that the increased attention on long COVID raises a crucial question: are there individuals who are living with post-illness symptoms stemming from other acute respiratory infections, and are they being overlooked?

The study authors note that post-acute infection syndromes have been observed before, with some cases resembling chronic fatigue syndrome following an infection-like episode. However, these syndromes often remain undiagnosed due to the broad range of symptoms and a lack of diagnostic tests.

The findings from this study suggest that there might be long-lasting health consequences from other respiratory infections that are currently going unnoticed. It’s worth noting that further research is needed to determine whether these symptoms have a similar duration to long COVID.

Experts in the field acknowledge that this study is part of a growing body of research aimed at understanding the long-term effects of post-viral symptoms.

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“We’re increasingly learning that acute viral infections like COVID, influenza, and possibly other respiratory viruses can trigger an inflammatory response. This response is a normal part of the body’s defense against the virus. However, in some individuals, it appears that the inflammatory response doesn’t completely subside after the acute illness and continues to linger in a chronic manner. It’s starting to seem like this prolonged inflammatory response may, at least in part, contribute to the post-influenza risks of heart attacks and strokes,” explained Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Tennessee. Dr. Schaffner was not involved in the study but shared his insights.

“We need to recognize these illnesses as real and significant. Initially, many healthcare providers may not have paid enough attention to patients reporting these symptoms. However, we’ve improved in this regard, and we’re now listening to patients more carefully. Over the past 15 years, the concept of chronic active inflammation has become a more defined scientific concept, leading to ongoing investigations,” he added.

Identifying Lingering Symptoms

The Centers for Disease Control and Prevention (CDC) defines long COVID as symptoms and conditions that persist or develop after a COVID-19 infection. To meet the CDC’s criteria, these symptoms must last for at least four weeks following the initial illness. On the other hand, the World Health Organization (WHO) defines long COVID as the continuation or development of new symptoms three months after the initial infection with these symptoms persisting for at least two months without any other explanation.

It’s estimated that at least 10% of individuals who have had COVID-19 may experience long COVID, which amounts to a minimum of 67 million people worldwide. However, determining the number of people living with lingering symptoms following non-COVID acute respiratory illnesses is challenging.

Dr. Dean Blumberg, the chief of pediatric infectious diseases at the University of California Davis, who was not involved in the study, points out that one of the challenges is the lack of a clear definition for what constitutes “long cold” symptoms.

“One of the issues that really has not been well done is there is no good definition for this yet. In order to advance the field, I think a specific case definition needs to be sorted out and agreed upon, and then it’ll be easier to define. And if you can define it better, then obviously, you can start looking more into what’s causing it and how to treat it.

Lack of Basic Long-term Symptom Tests

Another issue is the lack of a diagnostic test for identifying lingering symptoms in other acute respiratory illnesses, much like the situation with long COVID.

“To diagnose them, there’s no simple tests. So there’s no simple blood test, the clinical criteria has taken quite a long time. It took years to figure it out for chronic fatigue syndrome and with long COVID it just appears now that it’s sort of coalescing into an agreed upon definition. And that impacts the second question, which is how do you figure out treatment?” Blumberg said.

Long COVID shares many similarities with other post-viral conditions, such as chronic fatigue syndrome. Experts suggest that as our understanding of long COVID increases, it may also benefit people living with other persistent conditions.

“You can get some symptomatic relief. There is some genuine optimism. Many patients, although it takes a while, improve slowly but deliberately over time,” Schaffner said.