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News From the JAMA Network
January 4, 2022

Belief in Having Had COVID-19 Linked With Long COVID Symptoms

JAMA. 2022;327(1):26. doi:10.1001/jama.2021.23318

People who thought they’d been infected with SARS-CoV-2 had more persistent symptoms than those whose infections were confirmed by antibody testing in a recent study.

Researchers analyzed survey data and serology results from 26 823 adults in France. They found no relationship between the participants’ belief about whether they’d had COVID-19 and their antibody test results from blood samples collected between May and November 2020. In fact, about half of participants who believed that they’d had COVID-19 tested negative for SARS-CoV-2 antibodies. False-negative results were unlikely to have influenced the associations substantially, according to the authors.

The survey also asked participants about more than 20 symptoms associated with long COVID, including soreness, fatigue, poor concentration, trouble breathing, and chest pain. For most of the categories, a belief in having had COVID-19 was associated with currently having a symptom that had lasted for more than 8 weeks, after adjusting for age, sex, income, educational level, self-rated health, and depressive symptoms. However, loss of smell was the only long-term symptom associated with a positive serology test after adjustments.

The results “suggest that physical symptoms persisting 10 to 12 months after the COVID-19 pandemic first wave may be associated more with the belief in having experienced COVID-19 infection than with actually being infected with the SARS-CoV-2 virus,” the authors wrote in JAMA Internal Medicine.

Because another disease may underlie the symptoms that some patients attribute to COVID-19, the authors advised physicians to conduct a medical examination to determine the symptoms’ cause.