Understanding the Post COVID-19 Condition (Long COVID) and the Expected Burden for Ontario

Razak, Fahad; Katz, Gabrielle M.; Cheung, Angela M.; Herridge, Margaret S.; Slutsky, Arthur S.; Allen, Upton; Brown, Adalsteinn D.; Evans, Gerald A.; Kaplan, David; Mah, Linda; Munshi, Laveena; Dujovny, Manuel; Morris, Andrew M.; Rochon, Paula A.; Quinn, Kieran L.; Sander, Beate; Schwartz, Brian; Siddiqi, Arjumand; Tuite, Ashleigh R.; Verma, Amol A.; Jüni, Peter; Born, Karen

doi:10.47326/ocsat.2021.02.44.1.0

Cited by 8 publications

(9 citation statements)

References 49 publications

(71 reference statements)

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“…When all 9 components of the Oxford Stringency Index were disaggregated, Canada had among the most sustained stringent policies regarding restrictions on internal movement, cancellation of public events, restrictions on public gatherings, Box 1: Rationale for metrics used in the analysis • SARS-CoV-2 infections: The reported number of people infected with SARS-CoV-2 is useful for estimating work and school absences, and the potential long-term disruption to family life, work and education owing to persistent postviral chronic symptoms (long COVID). 3 Depending on vaccination status and baseline immunity from previous infection, a certain proportion of cases will lead to hospital admissions and deaths.…”

Section: Social and Public Health Restrictionsmentioning

confidence: 99%

Canada’s response to the initial 2 years of the COVID-19 pandemic: a comparison with peer countries

Razak

Shin

Naylor

et al. 2022

CMAJ

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The first known diagnosis of SARS-CoV-2 infection in Canada was in a patient in hospital in Toronto on Jan. 25, 2020. 1 At the time, few anticipated the intensity and duration of the COVID-19 pandemic, which has presented health systems and governments globally with challenges not encountered in a century. Through the first 2 years of the pandemic, the Canadian public bore the substantial burden of a range of public health measures, while maintaining a high degree of social solidarity with respect to policies such as the need for vaccines. 2 As the pandemic continues into its third year, a reflection on how Canada compared with similar nations during the first 2 years of the pandemic may allow both the public and our governments to better contextualize Canada's response to and experience of the pandemic. We consider how Canada compared with peer nations on several broad indicators that reflect the impact of both SARS-CoV-2 and measures to contain it, using publicly available data. How can we compare Canada with other countries?We sought to compare Canada's rates of SARS-CoV-2 infection, COVID-19-related and all-cause excess deaths, SARS-CoV-2 vaccination rates, pandemic-related societal restrictions and economic impacts of the pandemic with those of similar countries (see Box 1 for our rationale for metrics used in this analysis). We used data from Feb. 4, 2020, to Feb. 8, 2022, from several international data repositories: Our World in Data; the Organisation for Economic Co-operation and Development (OECD); the United Nations Educational, Scientific and Cultural Organization (UNESCO); and the International Monetary Fund. [14][15][16][17] We applied 3 criteria to choose comparator countries. First, similarity in economic and political models, given the policy and governance challenges of implementing public health restrictions in democracies, especially policies that affect personal liberty. Second, we considered similar per-capita income levels to be important, given this metric's correlation with health system capacity, which is critical to pandemic response and is in turn relevant for factors such as public health infrastructure to implement screening and vaccination, and hospital-and intensive care unit-based care for those with severe disease. Lastly, we considered population size, to a certain extent, given the logistics of population-wide pandemic management. We sought the largest defined grouping of countries that existed in prepandemic times that would fulfill these criteria. Given these considerations, we chose to compare the Group of 10 (G10) countries: Canada,

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Section: Social and Public Health Restrictionsmentioning

confidence: 99%

Canada’s response to the initial 2 years of the COVID-19 pandemic: a comparison with peer countries

Razak

Shin

Naylor

et al. 2022

CMAJ

Self Cite

View full text Add to dashboard Cite

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“…This work is an update of our 2021 Science Brief entitled: "Understanding the Post COVID-19 Condition (Long COVID) and the Expected Burden for Ontario". 2 It does not review the evidence for the post COVID-19 condition in children as children manifest disease in distinct ways with often distinct mechanisms. Every attempt has been made to acknowledge the uncertainty in the spectrum of risks associated with the post COVID-19 condition throughout the Science Brief.…”

Section: Introductionmentioning

confidence: 99%

Understanding the Post COVID-19 Condition (Long COVID) in Adults and the Expected Burden for Ontario

Quinn¹,

Katz²,

Bobos³

et al. 2022

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About Us: The Ontario COVID-19 Science Advisory Table is a group of scientific experts and health system leaders who evaluate and report on emerging evidence relevant to the COVID-19 pandemic, to inform Ontario's response. Our mandate is to provide weekly summaries of relevant scientific evidence for the COVID-19 Health Coordination Table of the Province of Ontario, integrating information from existing scientific tables, Ontario's universities and agencies, and the best global evidence. The Science Table summarizes its findings for the Health Coordination Table and the public in Science Briefs.

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“…Owing to the complexity and rapidly evolving landscape of research on risk factors, we do not aim examine patient-level factors (e.g., demographics, sex, or age) that could affect people's varying experiences with the long-term effects of COVID-19 or how post-COVID-19 condition may manifest differently among subgroups of people. 16,17 Rather, we aim to focus primarily on subtypes of clinical disease features.…”

Section: Objectivementioning

confidence: 99%

Subtypes of Post–COVID-19 Condition: A Review of the Emerging Evidence

Basharat¹,

Chao²,

McGill³

2022

cjht

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Post–COVID-19 condition is a growing health concern and has been associated with more than 200 possible symptoms. The diverse and varied ways the condition presents clinically creates challenges for developing standard diagnostic criteria, and for health systems aiming to provide effective treatment and management supports for people. To support health care, decision-makers and clinicians understand the different clinical presentations of the condition, we scanned the evidence base to examine early approaches being used to characterize and describe subtypes of post–COVID-19 condition. Subtypes can be developed with many different disease features and patient factors, but for this report we specifically reviewed potential subtypes based on symptoms and clinical presentation. We found that some of the early approaches used to develop subtypes are based on statistical methods that group together patterns of symptoms. These studies are beginning to reveal potential subtypes based on severity of symptoms, type and co-occurrence of symptoms, and symptoms affecting different organ systems. Many reported symptoms of post–COVID-19 condition are similar to previously characterized health conditions. In some cases, subtypes of post–COVID-19 may be manifestations of those other conditions. For example, certain subtypes may present with symptoms similar to myalgic encephalomyelitis/chronic fatigue syndrome or pulmonary fibrosis. It is uncertain whether those subtypes share the same or distinct pathophysiology and whether they may benefit from similar treatments. Early evidence comparing the variant of infection and its association with potential subtypes of post–COVID-19 condition is emerging, but the findings are currently mixed. Some studies suggest that variants such as Delta and Omicron may result in different clinical presentations, while other studies have not found significant differences. Further research assessing the association between variants and subtypes is likely needed. This review provides some implications and considerations for health systems should emerging research further characterize and validate proposed subtypes. These implications may be important for improving the diagnosis, treatment, and management of post–COVID-19 condition. With estimates in Canada suggesting that more than a million people could be affected by the condition, monitoring ongoing research on subtypes may help support the development of effective and tailored treatments, and guide health systems planning across the country.

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Understanding the Post COVID-19 Condition (Long COVID) and the Expected Burden for Ontario

Cited by 8 publications

References 49 publications

Canada’s response to the initial 2 years of the COVID-19 pandemic: a comparison with peer countries

Canada’s response to the initial 2 years of the COVID-19 pandemic: a comparison with peer countries

Understanding the Post COVID-19 Condition (Long COVID) in Adults and the Expected Burden for Ontario

Subtypes of Post–COVID-19 Condition: A Review of the Emerging Evidence

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