Originally published in The British Medical Journal, July 27, 2022

By Jacqui Wise

Electronic health records of 2.4 million people in the UK from January 2020 to April 2021 were analysed for a study published in Nature Medicine.1 The cohort included 486 149 people with confirmed SARS-CoV-2 infection who were not admitted to hospital, matched with a control group of 1.9 million people with no recorded evidence of coronavirus infection.

People who tested positive for the virus reported at least one of 62 symptoms more frequently 12 weeks after initial infection with SARS-CoV-2 than those who had not contracted the virus. The symptoms with the largest adjusted hazard ratios were anosmia (6.49 (95% confidence interval 5.02 to 8.39)), hair loss (3.99 (3.63 to 4.39)), sneezing (2.77 (1.40 to 5.50)) ejaculation difficulty (2.63 (1.61 to 4.28)), reduced libido (2.36 (1.61 to 3.47)), and shortness of breath (2.20 (1.57 to 3.08)). Other common symptoms were chest pain, a hoarse voice, and fever.

Shamil Haroon, associate clinical professor in public health at the University of Birmingham and senior author, said, “This research validates what patients have been telling clinicians and policy makers throughout the pandemic, that the symptoms of long covid are extremely broad and cannot be fully accounted for by other factors such as lifestyle risk factors or chronic health conditions.

“The symptoms we identified should help clinicians and clinical guideline developers to improve the assessment of patients with long term effects from covid-19 and to subsequently consider how this symptom burden can be best managed.”


The study also suggested that women, young people, and people from a black, mixed, or other minority ethnic group had an increased risk of long covid. Being from a poor background, smoking, and being overweight or obese were also linked with reporting of persistent symptoms.

A wide range of comorbidities were also associated with an increased risk of long covid symptoms including chronic obstructive pulmonary disease, benign prostatic hyperplasia, fibromyalgia, anxiety, and depression.

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