Primary Symptoms of Long Covid in a Large Cohort of Individuals and Implications for the Physical Therapy Profession

The purpose of this study was to examine the prevalence rate of long COVID in a large cohort of individuals that tested positive for COVID-19 (n = 124,313), to determine the primary symptoms associated with long COVID, and to determine the impact on health related quality of life. As there are no validated biomarkers for long COVID, screening is conducted by a detailed history and physical examination. 

A data set obtained from the 2022 Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS), gathering geographically proportional data across the United States (US) was utilized. The sample included 124,313 individuals that tested positive for COVID-19. Participants with symptoms of long COVID were analyzed and asked what the one primary symptom experienced was related to long COVID. We also examined the impact on health-related quality of life and compared individuals with COVID-19 who reported long COVID versus those that did not.

From the cohort of COVID-19 positive individuals, 26,783 reported symptoms of long COVID (22.1%). Tiredness or fatigue was the most common primary symptom (30.1%), followed by difficulty thinking or concentrating (10.0%); difficulty breathing or shortness of breath (18.7%); joint or muscle pain (5.3%); heart palpitations (2.8%), and dizziness upon standing (1.6%). Among individuals that had COVID-19, individuals with long COVID were also more likely to report fair or poor health status compared to individuals that did not report having long COVID (Wald chi-square = 301.3, OR = 2.1, 95% CI 1.9-2.1, p 0.001).

This study provides data from a large cohort of individuals with long COVID and details symptoms physical therapy professionals should be aware of, and that we can easily screen for on initial evaluation. Future work should include the development and validation of screening tools to identify individuals with symptoms of long COVID for physical therapy interventions. 

Physical therapy professionals can play a crucial role in managing the symptoms and improving the quality of life for individuals suffering from long COVID. Physical therapists are actively involved in developing and implementing innovative treatment strategies for long COVID, such as specialized exercise programs, breathing techniques, and neuromuscular re-education.