Fatigue and Headache Common Symptoms of Long Covid

By Pat Anson, PNN Editor

Fatigue, headache and muscle aches are the most common symptoms reported by people suffering from long covid, according to a comprehensive new study by researchers at the Medical College of Georgia (MCG). Cough, changes in smell and taste, fever, chills and cognitive problems also ranked high on the long list of lingering symptoms from COVID-19.

“There are a lot of symptoms that we did not know early on in the pandemic what to make of them, but now it’s clear there is a long COVID syndrome and that a lot of people are affected,” says lead author Elizabeth Rutkowski, MD, an associate professor of neurology at MCG.

The study findings, published in the journal ScienceDirect, involve the first 200 patients enrolled in the COVID-19 Neurological and Molecular Prospective Cohort Study (CONGA) in Georgia. Participants were recruited on average about four months after testing positive for the COVID-19 virus. Researchers eventually hope to recruit about 500 people for CONGA.

While the findings to date are not surprising and are consistent with what other investigators have learned about long covid, Rutkowski says it was surprising that symptoms initially reported by CONGA participants often didn’t match what further testing found.

For example, the majority of participants reported taste and smell changes, but objective testing of both senses did not always line up with what researchers found. Part of the discrepancy may be a change in the quality of their taste and smell rather than pure impaired ability.

“They eat a chicken sandwich and it tastes like smoke or candles or some weird other thing, but our taste strips are trying to depict specific tastes like salty and sweet,” Rutkowski says.

Eighty percent of the first 200 participants reported neurological problems, with fatigue the most common symptom:

Top Ten Symptoms of Long Covid

  1. Fatigue 68.5%

  2. Headache 66.5%

  3. Muscle aches 57%

  4. Cough 55.5%

  5. Changes in smell 54.5%

  6. Changes in taste 54%

  7. Fever 50%

  8. Chills 48%

  9. Nasal Congestion 47.5%

  10. Poor Appetite 47%

Nearly half the participants (47%) met the criteria for mild cognitive impairment, with 30% demonstrating impaired vocabulary, 32% having impaired working memory, and 21% reporting confusion. Researchers believe these cognitive issues may reflect the long-term isolation many participants experienced during the pandemic.

“You are not doing what you would normally do, like hanging out with your friends, the things that bring most people joy,” Rutkowski says. “On top of that, you may be dealing with physical ailments, lost friends and family members and loss of your job.”

Blacks Disproportionately Affected

Nearly two-thirds of the 200 CONGA participants were female, with an average age of 45. Nearly 40% were African-American. One of the study’s goals is to get a better understanding of how COVID-19 impacts African-Americans, who make up a third of Georgia’s population.

Researchers found that Black participants were disproportionately affected by long covid, with 75% meeting the criteria for mild cognitive impairment, compared to only 23.4% of white participants. Blacks were also more likely to have impaired vocabulary and memory. The findings likely indicate that cognitive tests assess different ethnic groups differently and may overestimate cognitive impairment in disadvantaged populations.

“African American patients appear to score significantly worse on quantitative cognitive testing compared to Non-Hispanic White patients, which likely underscore the disparities in how cognitive tests assess different ethnic groups due to various systemic factors including differences is socioeconomic status, psychosocial factors, and physical health,” researchers said.

Previous studies have found that Black and Hispanic individuals are twice as likely to be hospitalized by COVID-19, and ethnic and racial minorities are more likely to live in areas with higher rates of infection.