One-fifth of asymptomatic COVID patients developed long-haul symptoms

Almost one-fifth of asymptomatic COVID-19 patients later developed conditions associated with long-haulers, according to a new white paper from FAIR Health.

The healthcare transparency not-for-profit studied private insurance claims associated with 1.9 million patients who had a COVID-19 test, and then and looked at any health issues 30 days or more after their initial diagnosis. The analysis found 19% of asymptomatic individuals had at least one long-haul symptom, but the number is likely larger.

"A large number of asymptomatic people probably escaped attention in the early months of the pandemic, because testing wasn't that widely available," FAIR Health president Robin Gelburd said. "This should alert physicians and other providers to being attentive to those kinds of symptoms, because they may not have had a COVID-19 diagnosis in their chart."

The most common post-COVID-19 conditions include pain, breathing difficulty, high cholesterol, fatigue and hypertension. Anxiety was also commonly reported.

Meanwhile, half of patients who were hospitalized with COVID-19 had associated conditions after diagnosis, and 27.5% who had symptoms when tested later had linked conditions. The ranking of the most common post-COVID conditions varied by age group. For example, in the under 18 population, pain and breathing difficulties were the top two conditions.

"If someone tested positive, and escaped getting quite ill or were completely symptomatic, they should be attentive to the fact that they may still be exposed to some lingering symptoms," Gelburd said. "If they are experiencing different kinds of conditions that are atypical from the time before the diagnosis, they should communicate the fact that they tested positive, even though they may not have been quite sick."

FAIR Health also looked at the patients who were most likely to have died following a COVID-19 diagnosis. Patients who were hospitalized because of COVID-19 and then discharged were 46 times more likely to die than patients who were not hospitalized. People over the age of 70 also died at much higher rates, whether or not they had symptoms.

"Healthcare providers may be particularly attentive to follow up with post discharge as patients move further away from their discharge to make sure they're on sound footing and not experiencing any type of relapse or any adverse condition," Gelburd said.

People with pre-existing conditions also had mortality rates. The analysis found that people with intellectual disabilities, Alzheimer's disease or dementia had the highest mortality rates 30 days after an initial diagnosis. People with spinal cord injuries, schizophrenia or multiple sclerosis also experienced higher mortality rates.

The data came from claims collected between March 2020 and February 2021.