Americans infected with the coronavirus’s omicron variant are less likely to develop symptoms typical of long covid than those who had covid-19 earlier in the pandemic, according to the largest-ever study of who is most vulnerable to being sickened — or debilitated — by the virus’s lingering effects.
The analysis of nearly 5 million U.S. patients who had covid, a study based on a collaboration between The Washington Post and research partners, shows that 1 in 16 people with omicron received medical care for symptoms associated with long covid within several months of being infected. Patients exposed to the coronavirus during the first wave of pandemic illness — from early 2020 to late spring 2021 — were most prone to develop long covid, with 1 in 12 suffering persistent symptoms.
This pattern mirrors what leading doctors who treat long covid — and some scientists who study it — have noticed as the coronavirus pandemic evolves. But the reasons they offer for the shifting rates are closer to conjecture than to proof.
“Long covid is a complicated beast,” said Ziyad Al-Aly, director of the Clinical Epidemiology Center at Washington University School of Medicine in St. Louis and a major researcher into the phenomenon.
The findings also show that patients with certain underlying medical conditions are twice as likely as previously healthy people to seek care for symptoms associated with long covid:About 9 percent of patients with any of those preexisting conditions received treatment for long-covid symptoms in the six months after they came down with covid, compared with 4.6 percent who did not have those priorhealth problems, the analysis shows.
Obese patients were about three times as likely to report long-covid symptoms as those without any previous medical conditions, and people with lung diseases or kidney disorders were close behind.
These and other findings from The Post’s partnershiptrace the contours of a troubling ripple effect from the country’s worst public health crisis in a century. Researchers made rapid headway in understanding covid’s patterns of sickness and death and in developing vaccines and treatments. But as the pandemic enters its fourth year, the precise nature of long covid and the remedies for it reside in a black box.
Its causes have not advanced beyond theories. Its symptoms differ among patients, and, as the study demonstrates, some are common even before people catch the virus, making it hard at times to fathom what is caused by a coronavirus infection and what is incidental. Doctors treat the symptoms by borrowing from what they know about other diseases. And although physicians are familiar with post-viral syndrome — lingering symptoms after the flu, pneumonia, Epstein-Barr and other viral ailments — long covid tends to persist far longer.
“It’s scary not to be who I was before,” said Noemi Chiriac of Dallas, who has not regained her senses of taste and smell since a second bout of covid days before Christmas 2021, when the virus’s delta variant overlapped with the early stage of the omicron variant. “It’s losing your identity.”
Chiriac, 45 and single, finally can go on the miles-long walks she treasures, but becomes short of breath if she tries talking with anyone at the same time andneeds to nap for hours once she gets home.
In summer 2021, the aerospace and defense company where Chiriac worked chose her to compete for more-senior management jobs as part of a “talent pool.” She flubbed an interview. She was asked how she would handle situations with company leaders, but brain fog, lingering from her first round of covid seven months before, got in the way of her recalling their names.
“I could see their faces. I know exactly who they are, but I could not remember,” Chiriac said. She was taken out of the running for talent pool jobs.