The dangers posed by an infection with Sars-CoV-2 in the medium and long term are assessed quite differently depending on the perspective, sometimes even contradicting each other. For some, Long Covid is an enormous health burden from which many recovered people will suffer permanently, even if their infection is long over and possibly only mild. For the others, the complaints described are all too diffuse, and because they are also repeatedly reported in surveys and studies by non-infected people, it would therefore remain unclear whether Long Covid is an independent disease at all – or the expected long-term effects a pandemic that causes problems for everyone with chronic insecurity, fear, lack of contact, material losses and a depressive mood.
“We know that people are not necessarily healthy when the infection is over,” says Norbert Pfeiffer from the Mainz University Medical Center. The need to systematically research the Long Covid Syndrome and the variety of possible and actual long-term consequences is therefore great. According to WHO estimates, around ten percent of those infected subsequently struggle with it. The scientists at the University of Mainz were fortunate to have an extensive database as part of their so-called Gutenberg Covid 19 study to learn more about the ominous syndrome. Around ten thousand adults regularly provided information about their condition, and a number of test results and laboratory parameters were recorded. Children, who repeatedly plead for vaccination with reference to Long Covid, were not there.
“What is special about the study is that we had the entire spectrum of infected people with us, from completely asymptomatic to severe courses,” says epidemiologist and health care researcher Philipp Wild, who led the study. “In this way we were able to differentiate between knowingly and unknowingly infected people.” In the observation period from autumn 2020 to June 2021, 4.9 percent of the test subjects were infected, slightly more than a third of them unknowingly.
According to the self-assessment of those affected, almost 30 percent of those knowingly infected could no longer achieve their original performance after the infection. The proportion of those knowingly infected who stated their state of health as “worse” compared to the times before the pandemic was almost identical; among the unknowingly infected, however, it was 22.4 percent. However, 22 percent of those who were not infected reported that their state of health had deteriorated compared to the times before the pandemic. In view of this small difference, it remains scientifically challenging to differentiate Long Covid from other physical and mental impairments caused by the epidemic.
According to the Mainz study, almost 15 percent of both knowingly and unknowingly infected people feel restricted in their everyday life after an infection. Restrictions in their working life indicated between six and seven percent in both groups. Around 40 percent of both knowingly and unknowingly infected people still report one or more symptoms six months after infection, as listed in the World Health Organization’s post-Covid catalog.
It appears that the more severe the disease, the more likely it is to have long-term effects
“Women are affected significantly more often than men,” says study leader Wild. “However, there is no uniform clinical pattern of complaints.” Fatigue, tiredness, sleep disorders, loss of taste, shortness of breath and mood swings are particularly common months after the infection; but joint pain, memory loss and other limitations also occur. One in four people knowingly and one in five people unknowingly infected report being moderately or severely affected by these symptoms. However, around 40 percent of people without infection also report unspecific long-covid-like symptoms during the pandemic, which lasted six months or more.
“The good news is: Many of the complaints described go back over time,” says Philipp Wild. “That affects both the number and the intensity of the symptoms.” It is true that people with mild courses can also be affected by Long Covid. Nevertheless, there is a clear connection between the severity of symptoms in the acute phase of the disease and the likelihood of suffering long-term consequences.