Long Covid is a significant health crisis in China too

My comment: I've been following this researcher for the last few years. He doesn't strike me as the kind of guy who does Western chauvinism.

Long Covid, the constellation of long-term health effects caused by SARS-CoV-2 infection, is a significant global health crisis affecting at least 400 million individuals worldwide, with a cost of $ 1 trillion, equivalent to 1% of the global Gross Domestic Product.1 Long Covid can affect nearly every organ system resulting in various symptoms including fatigue, cognitive dysfunction, post-exertional malaise, autonomic dysfunction, and chronic conditions including new onset diabetes, cardiovascular disease, gastrointestinal and neurologic disorders.2 Long Covid can affect people across the lifespan and across age, race and ethnicity, and baseline health status.3

Chinese scientists were among the first to report Long Covid in people who survived the acute phase of Covid-19.4 However, these early seminal Chinese studies on Long Covid were exclusively from Wuhan – where the pandemic originated. Because of China’s zero Covid policies, infection rates plummeted quickly in Wuhan and were very low and sporadic outside of Wuhan for much of 2020, 2021, and 2022. However, China relaxed its zero Covid policies at the end of 2022 which led to explosion of cases – hundreds of millions of Chinese got infected with SARS-CoV-2 in the weeks and months following the lifting of zero Covid policies.

Now a report by Qin and colleagues provides insights into the colossal scale of Long Covid that resulted from those infections.5 Their large-scale survey of 74,075 Chinese participants, one of the largest studies of its kind and the first from China, shows that approximately 10%–30% of survey participants reported experiencing Long Covid symptoms such as fatigue, memory decline, decreased exercise ability, and brain fog.5 The features of Long Covid in China mirror those observed in studies conducted in other parts of the world.6 This underscores the consistency of Long Covid features across national borders, cultures and healthcare settings.

Interestingly, the authors show that despite having milder acute symptoms during reinfection, participants who experienced multiple infections were more likely to experience various Long Covid symptoms with greater severity. The authors show that having two infections is risk factor for many long-term Covid symptoms, and the risk increased exponentially when the number of infections exceeded two. These new data on Long Covid risk after reinfection are remarkably consistent with prior studies.7

Another critical insight from the study is the protective role of Covid-19 vaccines in reducing the incidence and severity of Long Covid. The data shows that vaccination, particularly with multiple booster shots, significantly decreases the risk of developing long-term symptoms. These findings are consistent with other studies showing that vaccines reduce the risk of Long Covid.8,9 Despite this, Covid-19 vaccine policies in much of the world consider effectiveness of vaccines in reducing risks of hospitalization and death during the acute phase of SARS-CoV-2 infection (which are most evident in older adults and people with comorbidities) and ignore their protective effect on Long Covid – a condition that affects people across the lifespan including young adults and children. Consequently, restrictive vaccine policies exclude children, young and healthy adults who may benefit from the beneficial effects of vaccine on Long Covid. Vaccine policies must holistically consider the benefit profile of Covid-19 vaccines including their effects in lowering the risk of Long Covid.

Looking forward, there are several key areas where Long Covid research must focus.1 There is an urgent need for comprehensive—and globally coordinated—Long Covid research strategy to understand the biological mechanisms, develop diagnostics, test therapeutics, characterize the long-term epidemiology and clinical course, evaluate health care delivery, and assess the impacts of Long Covid on patients, care givers, health systems, economies and societies.1

Equally important are policies to prevent Long Covid; support impacted individuals and their care givers; and ensure access, quality and equity of care.1 Policies are also needed to promote public awareness and facilitate professional training for health care providers.1

China, with its rich scientific history, is poised to contribute significantly to solving the puzzle of Long Covid. The international community must come together to identify areas of synergies in research, share data, resources, and expertise to accelerate progress on Long Covid.10 This includes fostering partnerships between governments, academic institutions, and the private sector, as well as engaging with patient advocacy groups to ensure that research is aligned with the needs and experiences of those affected by Long Covid.10

The study by Qin and colleagues offers the first comprehensive view of the state of Long Covid in China. The findings are both sobering and illuminating. Long Covid is clearly a serious public health challenge in China, as it is globally. These insights underscore the urgent need for a coordinated international response to address this significant and growing crisis. The stakes are high. Yet, throughout history, humanity has risen to the challenge of solving complex problems. We must now face Long Covid with the same resolve, ingenuity, and collaborative spirit that have driven our greatest achievements.