A recent study published in Nature Medicine found that people who were vaccinated had a slightly decreased risk of getting Long COVID six months after their initial diagnosis.
Long COVID, a condition that goes by the technical name post-acute sequelae of SARS CoV-2 infection (PASC), is a range of new, returning or ongoing symptoms following a COVID-19 infection. Typically, Long COVID symptoms begin to appear about four weeks after infection. There is no test to diagnose Long COVID, and the symptoms are significantly varied, ranging from fatigue, difficulty breathing and cough, to brain fog, sensory problems such as dizziness, diarrhea or stomach pain, joint or muscle pain, rash and many others.
A recent study published in Nature Medicine, part of a series of research projects by the Department of Veterans Affairs, looked at 33,940 people who experienced breakthrough infections after being vaccinated. As many other studies have shown, vaccination significantly decreases the risk of death or serious illness from COVID-19. What it didn’t do was clear things up regarding Long COVID.
The research found that people in the study who were vaccinated had a slightly decreased risk of getting Long COVID six months after their initial COVID-19 diagnosis, approximately 15% overall. There did appear to be a significant reduction in blood clotting and lung complications. However, in a comparison between vaccinated and unvaccinated people, there did not appear to be much difference between longer-term risks of neurological issues, gastrointestinal symptoms, kidney failure and other aspects of Long COVID.
“This was disappointing,” said Dr. Ziyad Al-Aly, M.D., lead author and chief of research and development service at VA Saint Louis Health Care System. “I was hoping to see that vaccines offer more protection, especially given that vaccines are our only line of defense nowadays.”
The U.S. Centers for Disease Control and Prevention recently released data suggesting Long COVID affects one in five adults younger than 65 who were diagnosed with COVID-19 and one in four of those 65 years and older. In both age groups, the infected patients had twice the risk of uninfected people for developing respiratory problems and lung symptoms, including pulmonary embolism. In addition, the older group was at higher risk of kidney failure, Type 2 diabetes, neurological problems and mental health issues.
The study looked at people in the U.S. who received two shots of the Moderna or Pfizer-BioNTech vaccines or a single shot of the Johnson & Johnson vaccine. It did not evaluate the effects from booster shots.
This is consistent with data from other countries, such as a recent study out of the U.K. published in the Lancet, which demonstrated a 50% decrease in risk in people who were vaccinated. But a study posted on medRxiv by University of Oxford scientists based on U.S. electronic medical records suggested vaccination didn’t decrease the risk of Long Covid for most symptoms.
Yet another study, published in the Annals of Clinical and Translational Neurology by investigators at Northwestern Medicine, found in a small study of 52 Long Covid patients, of which 77% had been vaccinated against COVID-19, vaccination didn’t seem to have any effect on cognitive function or fatigue.
The study’s lead author, Dr. Igor Koralnik, M.D., chief of neuro-infectious diseases at Northwestern, said, “There is a neutral effect of vaccination. It didn’t cure Long COVID. It didn’t make Long COVID worse.”
Anecdotally, some medical professionals feel that there has been an increase in vaccinated people having breakthrough infections and developing Long COVID. Some express concern that public health officials aren’t taking this increase seriously because they are discounting the odds and risks of Long COVID.
David Putrino, Ph.D., a Long COVID researcher who is director of rehabilitation innovation at the Mount Sinai Health System in New York, said, “We failed in our health messaging that death is not the only serious outcome of a COVID-19 infection. …I’m very concerned that what this is going to do is lead us into a continuation of this mass-disabling event we are seeing with Long COVID.”
Of course, one problem, particularly when looking at an older population, is many of the symptoms of Long COVID are also associated with other diseases, particularly disease of aging. Fatigue, breathlessness, muscle aches, heart palpitations, joint pain and memory and concentration issues, can also be associated with lung disease, heart disease and mild cognitive impairment.
“Identifying Long COVID in older adults with other medical conditions is tricky,” said Dr. Nathan Erdmann, M.D., Ph.D., an assistant professor of infectious diseases at the University of Alabama at Birmingham’s Heersink School of Medicine.
But with no specific diagnostic test for Long COVID, it can be difficult to diagnose. Generally, physicians specializing in Long COVID are starting by determining in older patients if an underlying medical condition is the reason for the symptoms, not necessarily COVID-19.
But Dr. Caitlin McAuley, D.O., one of two physicians at the Keck School of Medicine’s Covid clinic, said that if preexisting or new conditions are managed correctly and more tests come back negative, “there is probably an element of Long COVID.”
