Hair Loss Among the Top Post COVID Issues

Telogen Effluvium in Long COVID

Long COVID has come to refer to the cluster of symptoms that persist in patients long after the acute COVID infection has resolved. It has come to be appreciated that a variety of symptoms are possible in patients with Long COVID (also known as post acute sequelae of SARS-COV-2). Therefore, it is important to view COVID-19 as having two phases: an acute disease and a post acute phase.

A variety long-term symptoms are possible. Some have minimal effects on quality of life but some severely affect their quality of life. These symptoms and signs can affect activities of daily living and the ability to work, go to school or engage in hobbies. In some cases, long COVID leads to significant disability.

Authors of a new study set out to obtain data on exactly what symptoms patients were experiencing in the weeks and months after their acute COVID 19 infection. The did so by evaluating self-reported clinical symptom data via telephone calls over 90 days post-discharge. Among 4670 patients, the authors identified 45 symptoms across eight symptom clusters (neurological; mood disorders; systemic; respiratory; musculoskeletal; ear, nose, and throat; dermatological; and gastrointestinal).

Therefore, 4670 patients who agreed to participate in the follow-up survey and met the inclusion criteria were followed up by telephone. In total, 21,553 follow-up calls were performed between September 2020 and January 2021. The number of responders declined progressively with 3914 responses on day 1, 1303 responses on day 30, and 928 responses on day 90.

Most patients had symptoms at 30 and 90 days post discharge. 76.2% had at least one of the 45 identified COVID-19 symptoms at 30 days post-discharge, with 68.0% of patients having at least one of these symptoms persist to 90 days post-discharge .

The researchers found that most symptoms decreased in frequency between day 30 and 90. For example, fatigue, cough, chest pain, muscle pain, dizziness, tremors and dizziness decreased signficantly between day 30 and 90.

Several features increased in frequency between day 30 and 90 including hair loss, rhinorrhea (runny nose), lack of concentration, paresthesia, joint pains and memory loss

Most of the 8 symptom clusters saw improvement between day 30 and 90 - except dermatological issues. The skin issues actually became more of an issue between day 30 and 90. Specifically, hair loss was found to increase significantly in the weeks after COVID 19 infection. Of the eight symptom clusters, persistent symptoms were still markedly high (despite some improvement) were in the neurological, mood disorder, systemic, musculoskeletal, and ear, nose, and throat categories. Neurological, dermatological and mood issues were still present in more than 30 % of patients by day 90.

All in all the authors found that men were less likely to develop long COVID symptoms than women. Male patients had a lower risk shown fo neurological issues, muskuloskeletal, dermatological and mood disorders. The authors found found that alopecia increased over time that it mainly affected women, and at 90 days, the proportion of women who suffered alopecia was double that of men. At 90 days, the frequency of hair loss in women was 45.9%, compared with 21.2% in men.

Conclusions

This is an important paper capturing changes in 8 health domains during the post acute COVID period. Many health issues persist at 90 days and hair loss remains a top issue at that time point.

REFERENCE

Wong-Chew RM et al. Symptom cluster analysis of long COVID-19 in patients discharged from the Temporary COVID-19 Hospital in Mexico City. Ther Adv Infect Dis. 2022 Jan 11;9:20499361211069264.