Risk factors for "long-haul" COVID in people with rheumatic diseases identified

A new study by researchers at Hospital for Special Surgery (HSS) in New York City demonstrates over half of patients with rheumatic diseases who contracted COVID-19 during the pandemic and completed a COVID-19 survey, experienced so-called "long-haul" COVID, or prolonged symptoms of the infection, including loss of taste or smell, muscle aches and difficulty concentrating, for one month or longer.

Findings identified long-haul COVID was particularly high for smokers, patients with comorbidities such as asthma or lung disease, cancer, chronic kidney disease, diabetes, congestive heart failure or myocardial infarction, and those taking corticosteroids.

"Knowing the impact of this problem is critical," said Medha Barbhaiya, MD, MPH, a rheumatologist at HSS who led the study. "For rheumatology patients, long-haul COVID may be particularly challenging as these patients already have significant chronic health issues and warrants further investigation."

Dr. Barbhaiya and her colleagues presented their study, "Risk Factors for 'Long Haul' COVID-19 in Rheumatology Outpatients in New York City," at the American College of Rheumatology (ACR) annual meeting.

For the study, Dr. Barbhaiya's group emailed surveys to 7,505 men and women aged 18 years and older who had been treated at HSS for rheumatologic complaints between 2018 and 2020. Participants were asked if they had received a positive test for COVID-19 or if they had been told by a healthcare provider that they had contracted the infection.

The researchers defined long-haul COVID-19 infections as those with symptoms lasting one month or longer, whereas limited-duration cases were considered those with symptoms lasting less than one month.

Among the 2,572 individuals who completed the survey, nearly 56% of patients who reported having contracted COVID-19 said their symptoms lasted at least one month. Only two patients in the study had a previous diagnosis of fibromyalgia -; a condition marked by fatigue, muscle aches and other symptoms that have been associated with long-haul COVID -; suggesting that overlap between the two disorders is minimal.

Our findings do not suggest that symptoms of fibromyalgia are being misinterpreted as long haul COVID in patients with rheumatic diseases, which is something that has been raised as a possibility."

Lisa A. Mandl, MD, MPH, rheumatologist at HSS and senior author of the new study

HSS researchers plan to use the data as part of a longitudinal analysis of rheumatology patients with long-haul COVID to determine if the lingering symptoms of the infection interfere with their rheumatologic conditions. Ongoing surveillance of these patients will provide important insight on the long-term impact of COVID-19 in patients with rheumatic disease.