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- Wulf Hanson, Sarah, et al.
(författare)
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A global systematic analysis of the occurrence, severity, and recovery pattern of long COVID in 2020 and 2021
- 2022
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Importance: While much of the attention on the COVID-19 pandemic was directed at the daily counts of cases and those with serious disease overwhelming health services, increasingly, reports have appeared of people who experience debilitating symptoms after the initial infection. This is popularly known as long COVID.Objective: To estimate by country and territory of the number of patients affected by long COVID in 2020 and 2021, the severity of their symptoms and expected pattern of recovery.Design: We jointly analyzed ten ongoing cohort studies in ten countries for the occurrence of three major symptom clusters of long COVID among representative COVID cases. The defining symptoms of the three clusters (fatigue, cognitive problems, and shortness of breath) are explicitly mentioned in the WHO clinical case definition. For incidence of long COVID, we adopted the minimum duration after infection of three months from the WHO case definition. We pooled data from the contributing studies, two large medical record databases in the United States, and findings from 44 published studies using a Bayesian meta-regression tool. We separately estimated occurrence and pattern of recovery in patients with milder acute infections and those hospitalized. We estimated the incidence and prevalence of long COVID globally and by country in 2020 and 2021 as well as the severity-weighted prevalence using disability weights from the Global Burden of Disease study.Results: Analyses are based on detailed information for 1906 community infections and 10526 hospitalized patients from the ten collaborating cohorts, three of which included children. We added published data on 37262 community infections and 9540 hospitalized patients as well as ICD-coded medical record data concerning 1.3 million infections. Globally, in 2020 and 2021, 144.7 million (95% uncertainty interval [UI] 54.8-312.9) people suffered from any of the three symptom clusters of long COVID. This corresponds to 3.69% (1.38-7.96) of all infections. The fatigue, respiratory, and cognitive clusters occurred in 51.0% (16.9-92.4), 60.4% (18.9-89.1), and 35.4% (9.4-75.1) of long COVID cases, respectively. Those with milder acute COVID-19 cases had a quicker estimated recovery (median duration 3.99 months [IQR 3.84-4.20]) than those admitted for the acute infection (median duration 8.84 months [IQR 8.10-9.78]). At twelve months, 15.1% (10.3-21.1) continued to experience long COVID symptoms.Conclusions and relevance: The occurrence of debilitating ongoing symptoms of COVID-19 is common. Knowing how many people are affected, and for how long, is important to plan for rehabilitative services and support to return to social activities, places of learning, and the workplace when symptoms start to wane.Key Points: Question: What are the extent and nature of the most common long COVID symptoms by country in 2020 and 2021?Findings: Globally, 144.7 million people experienced one or more of three symptom clusters (fatigue; cognitive problems; and ongoing respiratory problems) of long COVID three months after infection, in 2020 and 2021. Most cases arose from milder infections. At 12 months after infection, 15.1% of these cases had not yet recovered.Meaning: The substantial number of people with long COVID are in need of rehabilitative care and support to transition back into the workplace or education when symptoms start to wane.
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- Wallin, Anders, et al.
(författare)
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Spatially dependent relationships between environmental factors and phytobenthic communities along the Swedish coast of the Baltic Sea, a numeric model approach
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The phytobenthic plant and animal communities are important components in the Baltic Sea ecosystem. In order to properly manage and monitor these communities the knowledge of structuring factors is important. In this study we used multivariate analyses to test the relative importance of environmental variables structuring the phytobenthic communities along the Swedish Baltic Sea coast, how the importance of these factors change with spatial scale and between the three main Baltic Sea sub-basins, the Baltic proper, Bothnian Sea and Bothnian Bay. We also studied the effect of these environmental factors for different species groups. The environmental factors included were salinity, wave exposure, substrate slope, depth and substrate type. For the analysis a large dataset of 1362 diving transects performed with comparable methods was used, describing the phytobenthic plant and animal species depth distribution and coverage. The environmental factors changed in importance at the different scales. The community-environment relationships also differed between the sub-basins, especially in the Bothnian Bay compared to the Baltic proper and Bothnian Sea. In the calculated best combination of factors correlating with the phytobenthic community the depth and the substrate were included in a majority of the analyses, both at different scales and in the different sub-basins. Differences in the correlation between the phytobenthic community and the environmental factors were also found between species groups. The differences between the spatial scales, the sub-basins and the species groups indicate that the criteria for environmental status, and stratification of sampling during local monitoring assessments, have to be area specific.
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