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Long referrals to COVID clinics dropped 79% after vaccine rollout

Referrals to Cambridge’s long-running COVID clinic dropped dramatically over the period August 2021 to June 2022, which the researchers say is likely due to the successful rollout of the vaccine.

According to the Office of National Statistics, as of July this year around 2 million people in the UK were living with self-reported long COVID – meaning symptoms persisted for more than four weeks after their first infection suspected coronavirus (COVID-19). Patients report symptoms such as fatigue, muscle aches, memory problems and shortness of breath more than six months after acute COVID-19, and a significant number of patients have not fully recovered two years after the initial infection.

Two recent studies suggested that vaccination strongly reduced long COVID symptoms one to three months after infection, but another study using a cohort of US Army veterans suggested a more modest reduction of 15% at six months. .

In May 2020, Addenbrooke’s Hospital, part of Cambridge University Hospitals NHS Foundation Trust (CUH), set up a lengthy COVID clinic, with patients referred to the clinic based on a number of criteria, one of which is the duration of symptoms of at least five months. . These patients tend to be those on the severe end of the symptom spectrum, having been referred after assessment by a team that includes a GP, mental health practitioners, physiotherapists and occupational therapists, among other specialists.

Researchers from the University of Cambridge’s Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID) and CUH analyzed data from the clinic and found a 79% drop in the number of patients referred to the clinic from August 2021 to June 2022, compared to August 2020 to July 2021. The decrease began five months after people began receiving a second dose of COVID-19 vaccines.

The six-month moving averages went from about 10 referrals per month to just one or two referrals per month. This effect has so far held until at least June 2022, despite four times as many cases per month of acute COVID-19 in England over the same periods.

Dr Ben Krishna from the University of Cambridge said: ‘The long COVID can have a significant impact on an individual’s life, and the large number of patients still showing symptoms many months after infection puts additional pressure. on our health services.

“We know that the deployment of vaccines had a major impact on the number and severity of COVID infections, and evidence from our clinic suggests that it also played an important role in reducing the rates of long-lasting COVID cases. the most serious.”

The researchers say it’s possible — but unlikely — that the emergence of the Delta variant also affected long COVID rates. However, the observed reduction in long COVID rates in August 2021 came from patients showing symptoms for five months, which they said would suggest a change from March 2021. This correlates well with second doses of vaccination in the UK , but the Delta wave only started in April 2021.

The team says they also can’t rule out previous infections providing immunity that protects against long COVIDs against reinfections; however, primary infections were more common than reinfections around March-April 2021.

The team observed no change in symptoms between people referred for long COVID before or after vaccination for any of the main symptoms such as fatigue (73% before vaccination versus 76% after vaccination) and shortness of breath (18% pre-vaccination versus 23% post-vaccination).

It is not yet clear what level of immunity is required to protect against long COVID, researchers say. As immunity wanes over time, booster shots — including variant-specific booster shots — may be needed to minimize long-term COVID risk.

CUH’s Dr Nyaradzai Sithole said: “As the virus continues to circulate and infect – and in many cases re-infect – people, it is important that everyone is up to date with their vaccinations. This will not only help prevent, or at least mitigate, their primary COVID infection, but should also reduce their risk of prolonged COVID. But it remains to be seen whether, with the emergence of new variants, we will start to see an increase in the number of long COVID cases.

The study is published in Clinical infectious diseases.

The research is funded by Addenbrooke’s Charitable Trust and the National Institute for Health and Care Research (NIHR), with support from the NIHR Cambridge Biomedical Research Centre.

Reference: Krishna BA, Metaxaki M, Wills MR, Sithole N. Reducing the incidence of long coronavirus disease referrals at Cambridge University Hospital’s Long Coronavirus Disease Clinic. Blink Infect Dis. 2022: ciac630. do I: 10.1093/cid/ciac630

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