By Jen Christensen | CNN
Millions of people are struggling with Covid–19 symptoms long after their initial infections. Two new studies – one focusing on pregnant women and the other on children – provide greater insight into the burden of this health problem that doctors say often goes unnoticed.
The first study indicates that 1 in 10 people who had Covid while pregnant will develop long-term symptoms. The findings were shared Monday at the annual meeting of the Society for Maternal-Fetal Medicine in National Harbor, Maryland.
The researchers used data from the National Institutes of Health’s Recover Initiative, a project created to determine the long-term effects of Covid in adults and children. Of the 1,503 pregnant people in the dataset, 9.3% reported experiencing symptoms six months or more after being infected. The most common symptom was feeling tired after light physical or mental activity. Some have also reported dizziness.
The percentage of pregnant people with long Covid is low compared to the proportion of the general U.S. population, some research shows. Estimates of the number of adults who develop long Covid range from 2.5% to 25%, although different studies have different definitions of how “duration” of Covid is defined. This study does not explain why the numbers may be different, but co-author Dr. Torri Metz, associate professor of obstetrics and gynecology and vice chair of obstetrics and gynecology research at University Health Utah, has some ideas.
“This could be because they have fewer baseline medical complications overall.” They are younger. It could also be that they have a different immune response,” Metz said.
A pregnant person’s immune system is generally more tolerant of “things that shouldn’t be there,” she said, so the mother’s body can accommodate and nourish a fetus with different genetics.
Often, pregnant people tend to get sicker when exposed to a virus because their immune system doesn’t have the robust response it usually would. This could mean that the pregnant body develops less inflammation, the immune system’s natural response to infection. Other studies have linked prolonged inflammation after Covid to impacts on the brain and damage to the lungs and kidneys.
“So maybe they don’t experience as much damage to surrounding organs and complex downstream consequences,” Metz said.
Pregnant people who developed long Covid also shared some common factors. Those who suffered from obesity, had been diagnosed with chronic anxiety or depression, or needed supplemental oxygen when ill had a higher risk of long Covid.
The quarter in which a person became ill with Covid did not appear to matter, and vaccination status was not a statistically significant factor. More than half of people with long Covid had been fully vaccinated. But many studies have shown that vaccination reduces the risk of severe illness, which can make long Covid more likely.
Metz said research found socio-economic factors affected long Covid numbers.
“It is worrying that a very high proportion of patients reported having difficulty paying their bills,” she said. “This raises red flags about what kind of access people have to the care they need.”
The study paints a clearer picture of who might be most susceptible to long Covid, says Dr. Amy Edwards, associate medical director of pediatric infection control at UH Rainbow Babies & Children’s Hospital, which manages long Covid. Covid clinic of the hospital.
“It is well known that chronic stress disrupts your immune system. Stress tends to stimulate a particularly maladaptive inflammatory response, and there is a well-known association with chronic stress,” said Edwards, who was not involved in the new research.
It will be helpful for doctors to know that if someone who had Covid during pregnancy is still tired eight weeks after birth, it could be long Covid rather than the usual fatigue that accompanies a newborn , she said.
An important next step – and already underway, according to the researchers – is to examine the outcomes of infants of pregnant people who developed long Covid.
The other new research, published last week in the journal Pediatrics, looked at various studies on children and found that up to 6 million of them developed long Covid.
Most young people who had suffered for a long time from Covid eventually recovered, studies suggest, but a third had symptoms even a year after their initial infection.
Long-term Covid symptoms in children included breathing problems like coughing, shortness of breath and chest tightness, as well as fatigue.
Edwards said it’s important not to downplay the impact of long Covid on children just because symptoms often go away.
“Imagine, as a teenager, missing two years of formative experience due to long Covid. I don’t even want to think about the long-term impacts of this,” she said.
Research also showed that children were at higher risk of certain autoimmune diseases like type 1 diabetes after Covid infection, even if the illness had been mild or asymptomatic. A US study reviewed by the authors found a 72% increased risk of developing diabetes within six months of an initial infection.
Studies have not fully explained what factors are common to children with long Covid. Those who experience food and housing insecurity and disrupted access to health care in general experience “an exacerbation of disease via decreased immunological functioning,” according to the new study.
Edwards said she and other doctors who run long-term Covid pediatric clinics across the country have recently noticed that the massive influx of patients they saw earlier in the pandemic has slowed, “which is fantastic.”
But there are still so many young people with long Covid that fewer patients just means a shorter waiting list, she said: Instead of waiting eight months to get into her clinic, patients now wait around five months.
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