A new study conducted in Italy reveals a reduction in long-COVID burden 7 months following the acute phase. The study, published in BMC Infectious Diseases, also shows that one-third of patients experienced long-lasting symptoms during almost 2 years of follow-up.

The study was based on the outcomes of 853 hospitalized COVID-19 patients and outpatients who had at least one follow-up visit after acute infection at San Paolo Hospital of the University of Milan from February 2020 to June 2023,.

The average age of patients was 62 years. Overall, 64.6% of the participants showed signs of persistent COVID at 3 months, 36.4% at 7 months, and 30.4% at 26 months. 

Fatigue, respiratory symptoms, brain fog, and chronic pain were the most common post-COVID conditions (PCCs) noted in follow-up visits. Loss of smell and taste were persistent symptoms seen only in patients infected with the original 2020 strain of the virus. 

“While anosmia/dysgeusia is prevalent in the first post-acute period, fatigue, respiratory sequelae, and to a lesser extent, brain fog emerged as the predominant long-term PCC phenotypes,” the authors wrote. 

Infection in first pandemic wave tied to long COVID

A number of factors were associated with persistent symptoms, including female sex and longer hospital stay. But acute infection in 2020 was the factor most associated with long COVID after adjusting for sex, disease severity, and preexisting conditions. 

Having had SARS-CoV-2 infection during the first pandemic phases appears to be associated with persistent PCC.

“Having had SARS-CoV-2 infection during the first pandemic phases appears to be associated with persistent PCC,” the authors wrote. This could be for a number of reasons, the authors said, including no vaccine history in that cohort and more severe clinical presentation. 

Children younger than 5 years exposed to maternal syphilis in utero, including those with congenital syphilis detected at birth, were at higher risk for all-cause hospitalization and had longer hospital stays, according to a study conducted in Brazil and published yesterday in JAMA Network Open.

Led by researchers from the London School of Hygiene and Tropical Medicine, the study involved data from the Center of Data and Knowledge Integration for Health Birth Cohort on 8.3 million single births from January 2011 to December 2015, with a 3-year follow-up. Of all children, 30,039 had been exposed to maternal syphilis, and 36,443 had congenital syphilis.

The incidence of syphilis, a bacterial infection caused by Treponema pallidum, has increased more than 200% among women of child-bearing age in high-income countries in recent years, the researchers noted.

"Syphilis can be transmitted sexually or vertically from mother to child during pregnancy, affecting the developing fetus," they wrote. "It is estimated that globally, maternal syphilis has caused 350,000 adverse birth outcomes every year, including stillbirth, preterm birth, low birth weight, neonatal deaths, and congenital infection." 

Congenital cases carry 6 times the risk

During the study, 65.1% of children with congenital syphilis and 31.3% with maternal syphilis were hospitalized at least once, compared with 19.0% in the unexposed group. 

These results suggest the need for close monitoring of exposed children and stress the importance of preventing syphilis in women of childbearing age.

Relative to unexposed children, those with congenital syphilis were at a 6-fold increased risk for first hospitalization (hazard ratio [HR], 6.19), and those exposed to maternal syphilis were at nearly twice the risk (HR, 1.90). The highest risk of hospitalization was noted in the first month of life among congenital syphilis patients (HR, 11.53). 

Although risk declined with increasing age, syphilis-exposed children had higher hospitalization rates than the unexposed group until age 36 months. Those exposed to syphilis in utero also had more and longer hospital stays.

"These results suggest the need for close monitoring of exposed children and stress the importance of preventing syphilis in women of childbearing age," the study authors wrote.

• Federal food-safety officials are investigating the source of a new Listeria monocytogenes outbreak that has been linked to 10 illnesses so far, the US Food and Drug Administration (FDA) said yesterday on its foodborne illness investigation website. The US Department of Agriculture (USDA) Food Safety Inspection Service (FSIS) and the FDA are both involved in the probe.
• Burkina Faso has reported its first Zika case, which involves a 6-year-old girl from Ziniare who was hospitalized for a suspected dengue infection but was negative for the disease, according to the latest weekly infectious disease bulletin from the Africa Centre for Disease Control and Prevention (Africa CDC). Follow-up testing at the country’s reference lab confirmed the Zika infection. The patient had no history of travel in the 15 days before her symptoms began.
• The USDA Animal and Plant Health Inspection Service (APHIS) today reported one more H5N1 avian flu detection in poultry, which involves a commercial layer facility in Aurora County, South Dakota. The farm has 700,000 birds. Since the virus began striking poultry in February 2022, outbreaks have led to the loss of 169 million birds across all 50 states and Puerto Rico.