December 28, 2022: Whether it’s the effect of vaccination, immunity to past infections, or evolution, doctors are starting to expect the Omicron variant of the coronavirus to be milder. They also hope it will be less likely to cause a long COVID-19.
It is worth taking steps to protect yourself from infection. But some medical professionals are cautiously confident that when other people develop COVID for a long time after an Omicron infection, it may be less debilitating.
But because prolonged COVID symptoms, such as brain fog and fatigue, can seem weeks or months after other people have recovered from acute infections, and because another seasonal surge of new infections is underway, it’s too early to say for sure whether Omicron will result in less or less severe long cases of COVID for those inflamed right now.
That said, there are encouraging signs that this could be the case, says Jonathan Whiteson, MD, co-director of NYU’s Langone Health Post Post-COVID Care Program and co-author of the American Academy of Physical Medicine’s long COVID remedy recommendations. and Rehabilitation (AAPMR).
“In clinical practice right now, we’re seeing a downward trend in long-term COVID rates as more people get vaccinated and reinforce and variants change,” Whiteson says.
There is a developing evidence framework that suggests those trends could mean good news for others concerned about their long-term threat of COVID.
A recent study, for example, found that an Omicron infection is only as likely to cause prolonged cases of COVID as the Delta variant. This study compared the effects of more than 56,000 people in the UK who became inflamed with Omicron between December 2021 and March 2022 and more than 41,000 more people with Delta. The researchers also found that Omicron is about 50% less likely to cause prolonged COVID in other vaccinated people less than 3 months before becoming inflamed, and 75% less likely to cause prolonged COVID. COVID when other people were vaccinated more than 6 months before their infection. They got sick.
Many of those patients in the U. K. research had milder cases, and the researchers only looked at symptoms that other people reported on a mobile app. Another recent study in Norway looked at symptoms reported by doctors treating patients with more severe and prolonged cases of COVID who were inflamed in December 2021 when Omicron and Delta were circulating. This Norwegian study found a similar risk of symptoms such as fatigue, cough, central palpitations, shortness of breath, and anxiety or depression up to four months after Omicron and Delta infections.
These potentially conflicting effects of studies in the United Kingdom and Norway may tell other parts of the same story, says Karin Magnusson, PhD, leader of the Norwegian study and researcher at the Norwegian Institute of Public Health in Oslo.
“It’s imaginable that the virus will subside, which translates into shorter COVID for most,” Magnusson says.
Omicron may also lead to fewer and less severe COVID cases as more people get vaccinated, especially as more people get boosters with the bivalent vaccine that protects against the original strains of the virus and Omicron.
In a study of 250,000 U. S. adults infected between August 2021 and January 2022, those who had been vaccinated had a 40% lower risk of COVID.
Separately, a knowledge meta-analysis of 10 studies with more than 1. 6 million participants found that receiving at least one dose of the vaccine before infection reduced the long-term threat of COVID by about 35%. Even when other people were only vaccinated after they were infected, vaccination still reduced the long-term COVID threat by about 27%.
“Vaccines are maximally effective when administered before infection,” says Alexandre Marra, MD, leader of the meta-analysis and researcher at Hospital Israelita Albert Einstein in São Paulo, Brazil.
“However, vaccines will offer some point of coverage to other people who have been immunized after infection,” Marra says.
A limitation of this meta-analysis and much of the other studies to date on the effect of vaccination on long-term COVID cases is that those studies were conducted based on the original vaccines and not on the new bivalent booster designed to protect against Omicron. It is therefore too early to say whether the new reinforcements, approved in the US, will be able to do so. With the U. S. being less than four months ago for adults and just a few weeks ago for very young children, they can provide more protection against the long COVID.
“Long COVID can take months to manifest after COVID infection, which means it’s still too early to know if the new bivalent vaccine is more effective than the original doses and boosters,” says Daniel Brannock, a knowledge researcher at RTI International who has long studied COVID-19.
Beyond the effect of vaccines, it’s also possible that Omicron could lead to fewer prolonged cases of COVID because it acts differently in the framework than previous strains of the virus, Marra says. Omicron turns out to basically cause upper respiratory tract infections. , which tend to have effects on the throat and sinuses and cause mild cold-like symptoms. Earlier variants of the pandemic caused lower respiratory infections, marked by pneumonia and more severe illness, Marra notes.
As with previous variants of the virus, other people might be at increased risk for long-term COVID when they have severe Omicron infections. A meta-analysis of 61 studies involving more than 74,000 patients with long-term COVID found that some of those for acute infections had long-term COVID, as did 75% of the sickest patients sent to intensive care units (ICUs). Similarly, a study of more than 200,000 other people with acute infections in Sweden found that only 1% of other people with acute mild cases had mild COVID, compared to 6% of hospitalized patients and 32% of those seen in the ICU.
“People hospitalized during the acute phase of COVID spread persistent symptoms more than other people who are not hospitalized,” says Akiko Iwasaki, PhD, director of the Center for Infection and Immunity at Yale University in New Haven, CT. “However, non-hospitalized people and even asymptomatic COVID infections can lead to COVID in the long term. “
And prolonged COVID remains incredibly common, affecting more than 29 million Americans and nearly one-third of patients with acute infections, according to AAPMR estimates. It can kill; The CDC’s National Center for Health Statistics reports at least 3500 deaths in the U. S. U. S. COVID long-term home, work, and school.
While there are still many unknowns about how to expect who will have prolonged COVID or who will have the worst symptoms, the emerging image from Omicron so far suggests some transparent steps other people can take to decrease their risk.
“People who are vaccinated and updated with boosters, adding bivalent, which is effective as opposed to existing subvariants of Omicron, are more opposed to severe COVID and have a lower incidence of prolonged COVID,” Whiteson said.
SOURCES:
Jonathan Whiteson, MD, co-director of the COVID Care Program at NYU Langone Health Post.
American Academy of Physical Medicine and Rehabilitation: “Long COVID/PASC. “
Lancet: “Delta-related long-term COVID threat as opposed to Omicron variants of SARS-CoV-2. “
Nature Communications: “Post-COVID-19 Medical Complaints After SARS-CoV-2 Omicron Infection vs. Delta Variants. “
Karin Magnusson, PhD, Researcher, Norwegian Institute of Public Health, University of Oslo and Lund, Sweden.
FDA: “Bivalent COVID-19 Vaccine Boosters. “
medRxiv: “Long Risk of COVID and Pre-COVID Vaccination: A Cohort Study Based on the EHR of the RECOVER Program. “
Antimicrobial Management and Healthcare Epidemiology: “The Effectiveness of Coronavirus Disease 2019 (COVID-19) Vaccine in the Prevention of Post-COVID Conditions: A Systematic of the Literature and a Meta-Analysis. “
Alexandre Marra, MD, Researcher, Hospital Israelita Albert Einstein, São Paulo, Brazil; Researcher, University of Iowa Carver School of Medicine, Iowa City.
FDA: “Coronavirus (COVID-19) Update: FDA Authorizes Moderna and Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as Booster Doses. “
FDA: “Coronavirus (COVID-19) Update: FDA Allows COVID-19 (Bivalent) Vaccines to Be Updated for Children Up to 6 Months of Age. “
Daniel Brannock, Research Data Scientist, RTI International.
CDC: “Respiratory Infections. “
European Centre for Disease Prevention and Control: “Prevalence of post-COVID-19 symptoms: systematic review and meta-analysis of cohort data, stratified through the recruitment context”.
Journal of Internal Medicine: “Diagnosis of post-COVID-19 condition: a cohort of occurrence based on population, related factors, and health care use through acute infection severity. “
Akiko Iwasaki, PhD, Director, Center for Infection and Immunity, Yale University.
American Academy of Physical Medicine and Rehabilitation: “PASC Panel. “
National Center for Health Statistics: “Identification of deaths with post-acute sequelae of COVID-19 from the literal of the death certificate: United States, from January 1, 2020 to June 30, 2022. “
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