End of long covid … or is it?

4 minute read

Queensland’s Chief Health Officer says it’s time to put the label to bed, but others in the sector beg to differ.

Queensland Chief Health Officer Dr John Gerrard has called for the term “long covid” to be scrapped based on research which found the syndrome may not be the distinct and severe illness it was first believed to be.

Dr Gerrard’s move has proven controversial, with one prominent long covid clinician researcher calling his comments “disappointing”.

The research in question, which Dr Gerrard co-authored, will be presented at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in Barcelona this April.

It’s not an entirely new piece of research, but rather an update to a previous study that Dr Gerrard and colleagues presented at ECCMID last year.

The observational cohort study looked at around 5000 Queenslanders who experienced covid or flu-like symptoms in mid-2022.

Half of the study population tested positive to covid on PCR, around 20% tested negative to covid but positive to influenza on PCR and the remainder were negative for both covid and flu.

At follow-up one year later, around 16% reported ongoing symptoms and around 3% reported moderate-to-severe functional impairment.

Off the back of these results, the authors said long covid “manifested as a post-viral syndrome indistinguishable from influenza and other respiratory illnesses”.

During the first phase of the pandemic, they said, long covid may have appeared to be a distinct and severe illness due to the high volume of covid cases.

Dr Gerrard went a step farther in comments to the media and called for the public to stop using the phrase entirely.

“Furthermore, we believe it is time to stop using terms like ‘long covid,” he said.

“They wrongly imply there is something unique and exceptional about longer-term symptoms associated with this virus.

“This terminology can cause unnecessary fear, and in some cases, hypervigilance to longer symptoms that can impede recovery.”

Reactions have been mixed.

While some clinicians have welcomed the results given the lack of published Australian research in the area, others have called the conclusions overstated.

Associate Professor Anthony Byrne, a respiratory specialist who runs the long covid clinic at St Vincents Hospital in Sydney, is one such clinician.

“Unfortunately, there are thousands of people that are still suffering from post-acute covid sequelae … and just because you don’t want to talk about something doesn’t mean it doesn’t exist,” he said.

“It’s a recognised condition, it still affects people and we’re still doing lots of research on it for that very reason.”

There were plenty of political reasons to dismiss the importance of long covid, Professor Byrne said.

“[Calling to scrap ‘long covid’] is completely the wrong message and it’s very disappointing to me that a Chief Health Officer is making these comments,” he said.

Professor Byrne also questioned the robustness of the study, given that it relied on people’s recollections of their illness 12 months down the road.

Paediatric infectious diseases physician Professor Philip Britton, who is a member of the Long Covid Australia research collaboration, said the data indicating that most people recover from covid without long-term effects was “good news”.

“Equally, that some people have persistent symptoms following other viruses which can impact on quality of life and function is a message that needs better recognition,” said Professor Britton.

“However, efforts to dismiss long covid effects in at least some people by dismissing the term altogether will likely not assist.”

Murdoch University’s Professor Jeremy Nicholson took issue with the study’s methodology and said that without individual laboratory pathophysiological assessments it would be impossible to say that the participants’ symptoms were “indistinguishable” from post-viral syndromes.

“The absence of evidence is different from evidence of absence – so the authors’ assertion that long covid is the same as flu-related post-viral syndrome is not proven, even if long covid is indeed a post-viral syndrome (which it is),” Professor Nicholson said.

ECCMID 2024 will take place from 27 to 30 April in Barcelona, Spain.

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