Long COVID: Risks, Symptoms, and Vaccination Insights

Q: Long COVID: Risks, Symptoms, and Vaccination Insights

Hello： 1. <br>Severe COVID-19 symptoms are associated with a higher incidence of sequelae, so the most important measures are vaccination and the early use of antiviral medications. <br>2. <br>There is no direct correlation between the COVID-19 virus and the influenza virus, so w

Long COVID-19 sequelae

Hello Doctor, I would like to ask: 1) After contracting COVID-19, are individuals with moderate to severe cases more likely to experience Long COVID symptoms, while those who are asymptomatic or have mild cases are relatively less likely to have Long COVID symptoms? 2) For individuals who previously had H1N1, if they contract COVID-19 again, are they less likely to develop moderate to severe symptoms, and are they less likely to experience Long COVID symptoms? 3) I received my first dose of BNT on September 27 of last year, but I hesitated to get the second dose because I felt it exacerbated my ankylosing spondylitis.
Now that I want to get the second dose, it is no longer available.
I would like to ask the doctor, since it has been over six months since September 27, if I were to receive the second dose of BNT now, would the increase in antibodies be negligible? If it is indeed negligible, what should I do next? Thank you, Doctor.

Zhengzhong, 10~19 year old female. Ask Date: 2022/04/15

Dr. Chen Mingong reply Influenza

Hello: 1.
Severe COVID-19 symptoms are associated with a higher incidence of sequelae, so the most important measures are vaccination and the early use of antiviral medications.
2.
There is no direct correlation between the COVID-19 virus and the influenza virus, so we will not investigate past influenza virus infections.
However, it may reflect that individuals have a weaker immune response.
3.
Antibody levels decrease four to six months after vaccination; currently, it is recommended to complete a total of four doses, especially for healthcare workers and individuals with compromised immune systems.

Reply Date: 2022/04/15

More Info

Understanding Long COVID is crucial, especially as we continue to navigate the aftermath of the COVID-19 pandemic. Your questions touch on several important aspects of Long COVID, vaccination, and individual health conditions. Let’s break down your inquiries:
1. Risk of Long COVID in Severe vs. Mild Cases: Research indicates that individuals who experience moderate to severe COVID-19 are at a higher risk of developing Long COVID compared to those who have mild or asymptomatic cases. Long COVID can manifest in various ways, including fatigue, cognitive dysfunction (often referred to as "brain fog"), respiratory issues, and other systemic symptoms. The severity of the initial infection seems to correlate with the likelihood of experiencing these lingering effects. However, it’s important to note that even individuals with mild cases can develop Long COVID, albeit at a lower rate. Factors such as age, pre-existing health conditions, and overall immune response also play significant roles.

2. Previous H1N1 Infection and COVID-19 Severity: The relationship between past infections, such as H1N1, and the severity of subsequent COVID-19 infections is not straightforward. While some studies suggest that prior exposure to certain viruses may offer some level of cross-protection, this is not guaranteed. The immune response generated by H1N1 does not directly translate to immunity against COVID-19, as they are caused by different viruses with distinct characteristics. Therefore, having had H1N1 does not necessarily mean an individual will experience a milder case of COVID-19 or be less likely to develop Long COVID.

3. Vaccination and Antibody Response: Regarding your vaccination history, it’s important to understand that the immune response to vaccines can wane over time. After receiving the first dose of the BNT vaccine, your antibody levels would have peaked and then gradually declined over the months. Generally, it is recommended to receive booster doses to maintain adequate immunity, especially in the context of emerging variants. If you are considering getting the second dose now, it may still provide a boost to your immune system, even if the initial antibody response has diminished. The benefits of vaccination extend beyond just antibody levels; they also enhance the overall immune memory and T-cell response, which are crucial for long-term protection against severe disease.

If you are concerned about the potential exacerbation of your ankylosing spondylitis symptoms due to vaccination, it is advisable to consult with your healthcare provider. They can help assess the risks and benefits based on your specific health situation. If the BNT vaccine is currently unavailable, you may want to explore other vaccine options that are authorized in your area.

In summary, while individuals with severe COVID-19 are at a higher risk for Long COVID, mild cases can also lead to lingering symptoms. Previous infections like H1N1 do not guarantee protection against severe COVID-19 outcomes. Lastly, even if antibody levels have declined, receiving a booster can still be beneficial for your immune response. Always consult with your healthcare provider for personalized medical advice tailored to your health conditions and vaccination history.

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