The risk of contracting long COVID may have been exaggerated due to flawed research, leading to unnecessarily high levels of anxiety about suffering from it, a new study has suggested.
“Major flaws” in the literature on the condition likely exaggerated the true threat of contracting it, the new research argues.
For most people with COVID-19, they feel better within days or weeks, but some can have symptoms for longer than three months.
Fatigue, brain fog, chest pain and shortness of breath are reported as symptoms by those who have long COVID – which is officially known as post-acute sequelae of COVID-19 (PASC).
Now, researchers from the UK, along with Denmark and the USA, say “many scientific publications” overestimated the prevalence of long COVID because of “overly broad definitions, lack of control groups, inappropriate control groups, and other methodological flaws”.
Instead, the authors of the new study argue that the symptoms are common among upper respiratory viruses.
The research team said this lack of definition could end up leading to an increase in healthcare spending and more anxiety, as well as misdiagnoses and a diversion of funds.
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Long COVID patient: ‘I lost my identity’
Concerns about too many symptoms and no required link to COVID
Published in the British Medical Journal’s Evidence-Based Medicine, the new paper looked at the definition of the condition by several global health organisations – including the National Institute for Health and Care Excellence (NICE) and the World Health Organisation (WHO).
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The study argues none of the definitions “requires a causal link” to COVID-19 infection, adding any symptoms that happen after a confirmed or suspected infection could be considered consistent with long COVID.
“In general, in the scientific literature, imprecise definitions have resulted in more than 200 symptoms being associated with the condition termed long COVID,” the researchers said.
Researchers also said the studies in the early stages of the pandemic are more likely to have included fewer patients with mild or no symptoms, which could have led to a sampling bias.
They said: “Our analysis indicates that, in addition to including appropriately matched controls, there is a need for better case definitions and more stringent (long COVID) criteria, which should include continuous symptoms after confirmed SARS-CoV-2 infection and take into consideration baseline characteristics, including physical and mental health, which may contribute to an individual’s post-COVID experience.”
Research in the future should include properly matched groups, the paper added, as well as “sufficient” follow-up time following infection.
The study’s authors also want to see “internationally established” diagnostic criteria and called for future studies to avoid “umbrella terms” and instead “narrowly define” the symptoms.
“Ultimately, biomedicine must seek to aid all people who are suffering,” the research team added. “In order to do so, the best scientific methods and analysis must be applied.
“Inappropriate definitions and flawed methods do not serve those whom medicine seeks to help.
“Improving standards of evidence generation is the ideal method to take long COVID seriously, improve outcomes, and avoid the risks of misdiagnosis and inappropriate treatment.”
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2:19
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Study criticised for ‘some odd conclusions’
However, Dr Adam Jacobs, senior director of biostatistical science at Premier Research, said although the paper “makes some sensible points” it goes on “to draw some odd conclusions”.
He added: “It is, of course, inevitable that much of this literature is imperfect.
“Long COVID simply didn’t exist four years ago, so researchers have had to get to grips with a new and challenging topic at top speed.
“It is, therefore, not surprising that different studies have different estimates of the prevalence of long COVID, as studies have used different case definitions, different populations etc.”
Dr Jacobs said a survey by the Office for National Statistics (ONS), which was discontinued in March, found that 1.9 million people in the UK had long COVID.
He said this was a “staggeringly high” number.
“We don’t know how long those people will remain ill,” he added. “If we are lucky, most of them will be healthy again within a year or two.
“If we are unlucky, a large number of them may have a permanent disability.”
A 92-year-old man has been sentenced to life with a minimum term of 20 years in prison for the rape and murder of an elderly widow nearly 60 years ago.
Ryland Headley was found guilty on Monday of killing 75-year-old Louisa Dunne at her Bristol home in June 1967, in what is thought to be the UK’s longest cold case to reach trial, and has been told by the judge he “will die in prison”.
The mother-of-two’s body was found by neighbours after Headley, then a 34-year-old railway worker, forced his way inside the terraced house in the Easton area before attacking her.
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The UK’s longest cold case to reach trial
Police found traces of semen and a palm print on one of the rear windows inside the house – but it was about 20 years before DNA testing.
The case remained unsolved for more than 50 years until Avon and Somerset detectives sent off items from the original investigation and found a DNA match to Headley.
He had moved to Suffolk after the murder and served a prison sentence for raping two elderly women in 1977.
Prosecutors said the convictions showed he had a “tendency” to break into people’s homes at night and, in some cases, “target an elderly woman living alone, to have sex with her despite her attempts to fend him off, and to threaten violence”.
Image: Louisa Dunne in 1933. Pic: Avon and Somerset Constabulary
Image: Headley during his arrest. Pic: Avon and Somerset Constabulary
Headley, from Ipswich, who did not give evidence, denied raping and murdering Ms Dunne, but was found guilty of both charges after a trial at Bristol Crown Court.
Detectives said forces across the country are investigating whether Headley could be linked to other unsolved crimes.
Mrs Dunne’s granddaughter, Mary Dainton, who was 20 when her relative was killed, told the court that her murder “had a big impact on my mother, my aunt and her family.
“I don’t think my mother ever recovered from it. The anxiety caused by her mother’s brutal rape and murder clouded the rest of her life.
“The fact the offender wasn’t caught caused my mother to become and remain very ill.
“When people found out about the murder, they withdrew from us. In my experience, there is a stigma attached to rape and murder.”
Image: The front of Louisa Dunne’s home. Pic: Avon and Somerset Constabulary
Image: Louisa Dunne’s skirt. Pic: Avon and Somerset Constabulary
Finding out her grandmother’s killer had been caught after almost six decades “turned my life upside down,” she said.
“I feel sad and very tired, which has affected the relationships I have with those close to me. I didn’t expect to deal with something of such emotional significance at this stage of my life.
“It saddens me deeply that all the people who knew and loved Louisa are not here to see that justice has been done.”
Image: Palmprint images. Pic: Avon and Somerset Constabulary
After her statement, Mr Justice Sweeting told Mrs Dainton: “It is not easy to talk about matters like this in public.
“Thank you very much for doing it in such a clear and dignified way.”
The judge told Headley his crimes showed “a complete disregard for human life and dignity.
“Mrs Dunne was vulnerable, she was a small elderly woman living alone. You treated her as a means to an end.
“The violation of her home, her body and ultimately her life was a pitiless and cruel act by a depraved man.
“She must have experienced considerable pain and fear before her death,” he said.
Sentencing Headley to life imprisonment with a minimum term of 20 years, the judge told him: “You will never be released, you will die in prison.”
Detective Inspector Dave Marchant of Avon and Somerset Police said Headley was “finally facing justice for the horrific crimes he committed against Louisa in 1967.
“The impact of this crime has cast a long shadow over the city and in particular Louisa’s family, who have had to deal with the sadness and trauma ever since.”
The officer praised Ms Dainton’s “resilience and courage” during what he called a “unique” case and thanked investigators from his own force, as well as South West Forensics, detectives from Suffolk Constabulary, the National Crime Agency and the Crown Prosecution Service (CPS).
Three managers at the hospital where Lucy Letby worked have been arrested on suspicion of gross negligence manslaughter.
They were in senior roles at the Countess of Chester Hospital in 2015 and 2016 and have been bailed pending further enquiries, Cheshire Constabulary said. Their names have not been made public.
Letby, 35, was found guilty of murdering seven children and attempting to murder seven more between June 2015 and June 2016 while working in the hospital’s neonatal unit.
Detective Superintendent Paul Hughes explained that gross negligent manslaughter focuses on the “action or inaction of individuals”.
There is also an investigation into corporate manslaughter at the hospital, which began in October 2023.
That focuses on “senior leadership and their decision-making”, Mr Hughes said. The intention there is to determine whether any “criminality has taken place concerning the response to the increased levels of fatalities”.
The scope was widened to include gross negligence manslaughter in March of this year.
Image: Lucy Letby was found guilty of murdering seven children and attempting to murder seven more
Mr Hughes said it is “important to note” that this latest development “does not impact on the convictions of Lucy Letby for multiple offences of murder and attempted murder”.
He added: “Both the corporate manslaughter and gross negligence manslaughter elements of the investigation are continuing and there are no set timescales for these.
“Our investigation into the deaths and non-fatal collapses of babies at the neo-natal units of both the Countess of Chester Hospital and the Liverpool Women’s Hospital between the period of 2012 to 2016 is also ongoing.”
Earlier this year, lawyers for Lucy Letby called for the suspension of the inquiry, claiming there was “overwhelming and compelling evidence” that her convictions were unsafe.
Their evidence has been passed to the Criminal Cases Review Commission (CCRC), which investigates potential miscarriages of justice, and Letby’s legal team hopes her case will be referred back to the Court of Appeal.
As we pulled back the hospital curtain, he was hunched over and clearly in pain.
He had climbed off the hospital bed to greet us with a polite smile, then hobbled back to lie down again.
Every breath was uncomfortable, but he wanted to share the horrible reality of knife crime.
Image: The young knife attack victim in Manchester
“I’ve never in my life been stabbed so I don’t know how it’s meant to even feel,” he said.
“The pain came when I realised the blood’s just spitting out of the side of my rib cage and that’s when I started panicking.
“My lungs felt like they were filled with blood… I thought each breath that I take, I’m going to drown in my own blood.
“I just felt as though I was slowly slipping away.”
Paramedics helped save his life and got him to the hospital in Manchester.
Sky News cannot name the young victim or go into the details of the attack because the police are investigating his case.
We were alongside a support worker called Favour, who is part of a growing team called Navigators. They go into hospitals to help young victims of violence.
While checking on how his recovery is going, she gently asked what he wanted to do next.
“You should have the right to feel safe,” she said to him.
“So don’t blame yourself for what happened… we are going to be there to help you.”
Image: Favour talks with the victim
‘Scarring and traumatic’
In a corridor outside the major trauma ward at the Manchester Royal Infirmary, Favour said: “They are often scared, often really tired from being in hospital.
“It does stay with you, not just for a couple of weeks, but it can go on for months, years, because it is something very scarring and traumatic.
“Having someone to talk to, being able to be very vulnerable with… that can lead you to find different spaces that are safe for you, can make a huge difference.”
In the adjacent Children’s Hospital in Manchester, we met the clinical lead at the Greater Manchester Violence Reduction Unit.
Image: Support worker Favour is part of a team called Navigators
Dr Rachel Jenner is a senior consultant who expanded her emergency department work into the wider mission of violence reduction after treating one particular young stab victim.
“When he arrived at the hospital, he was obviously very distressed and stressed,” she said. “A little bit later on, when things were stable, I asked him if he wanted me to call his mum.
“When I asked that question, he just kind of physically crumpled on the bed and just looked like the vulnerable child that he was, and that was really impactful for me.”
Image: Dr Rachel Jenner
‘Positive results’
The Violence Reduction Unit was established in 2019 with a commitment from the city’s authorities to work together better to prevent violence and deal with it efficiently when it occurs.
Dr Jenner still treats young knife crime victims, but revealed the number of stab-related admissions is falling in her hospital.
“The trend is downwards,” she confirmed. “We’ve definitely seen some positive results.”
The latest statistics in England and Wales show the number of hospital admissions for assault by a sharp object fell by 3% to 3,735 admissions in the year ending September 2024.
“We’re never complacent,” Dr Jenner said. “You reality check yourself all the time, because obviously if… someone gets stabbed, then it’s quite possible that I’ll be treating them.”
She said the Navigators are crucial to working with young patients.
“They have a really different way of engaging with young people, they’re much better at it than many other professionals,” she said.
“It’s not a one-size-fits-all model, they actually wrap around that support according to circumstances… that’s a really positive improvement.”
Tacking violence ‘like infectious disease’
Dr Jenner added: “We try and take a public health approach to violence reduction. In the same way that we would address an infectious disease, if we can use those methods and principles to look at violence.
“Not just reacting when it happens, but actually looking at how we can prevent the disease of violence, that in the long term will have a bigger impact.”
The key is teamwork, Dr Jenner said. Collaboration between the police, community leaders, victim support, health workers and people in education has noticeably improved.
The hospital also sends consultants into schools to teach pupils how to stop bleeds as part of an annual nationwide initiative that reaches 50,000 young people.
At a Stop The Bleed session in Bolton, Greater Manchester, we met 11 and 12-year-olds growing up with the threat of knife crime.
One Year 7 boy said: “There was a stabbing quite near where I live so it does happen, but it’s very crucial to learn how to stop this bleed and how to stop deaths.”
Another two friends talked about a boy their age who had been involved in an incident with a knife.
“No one would expect it for someone that young,” one said. “They’re just new to high school, fresh out of primary, and they shouldn’t just be doing that, too young.”
Image: Sanaa Karajada
‘We are dealing with it every day’
Their school has decided to tackle the problem of knife crime head-on rather than pretend it isn’t affecting their pupils.
The pastoral lead at the school, Sanaa Karajada, told Sky News: “We are dealing with it every single day, so we have policies and procedures in place to prevent any escalations in our schools or in the community.
“It is very, very worrying and it’s upsetting that [students] are having to go through this, but you know we’ve got to be realistic… if we are shying away from it, we’re just saying it’s not a problem.
“But it is a problem within the community, it’s a problem in all of the UK.”
The government has pledged to halve knife crime within a decade.
These signs of progress may offer some hope, but there is still so much work to do.