Long Covid symptoms: hair loss and reduced sex drive among wider long-term health effects, study finds

Hair loss and a reduced sex drive are among a wider set of long Covid symptoms than previously thought, new research suggests.

The study, published in Nature Medicine, found that symptoms of long Covid are extremely broad and cannot be fully accounted for by other factors, such as lifestyle or chronic health conditions.

What are the symptoms of long Covid?

Researchers from the University of Birmingham analysed anonymised electronic health records of 2.4 million people in the UK alongside a team of clinicians and researchers across England.

The data, taken between January 2020 and April 2021, comprised of 486,149 people with prior Covid infection, and 1.9 million people with no indication of coronavirus infection after matching for other clinical diagnoses.

Using data from patients that had not been admitted to hospital, the team found that patterns of symptoms from coronavirus tended to be grouped into three distinct categories. These are:

• respiratory symptoms
• mental health
• cognitive problems

Researchers found that while the most common symptoms include loss of smell, shortness of breath and chest pain, others include amnesia, an inability to perform familiar movements or commands, and hallucinations.

People who tested positive for the virus reported 62 symptoms much more frequently 12 weeks after initial infection than those who had not contracted the virus, the study found.

Senior author Dr Shamil Haroon, associate clinical professor in public health at the University of Birmingham, explained: “This research validates what patients have been telling clinicians and policy makers throughout the pandemic – that the symptoms of long Covid are extremely broad and cannot be fully accounted for by other factors such as lifestyle risk factors or chronic health conditions.

“The symptoms we identified should help clinicians and clinical guideline developers to improve the assessment of patients with long-term effects from Covid-19, and to subsequently consider how this symptom burden can be best managed.”

The NHS lists says there are many symptoms that can occur after a Covid infection, with the main signs including the following:

• extreme tiredness (fatigue)
• shortness of breath
• chest pain or tightness
• problems with memory and concentration ("brain fog")
• difficulty sleeping (insomnia)
• heart palpitations
• dizziness
• pins and needles
• joint pain
• depression and anxiety
• tinnitus, earaches
• feeling sick, diarrhoea, stomach aches, loss of appetite
• a high temperature, cough, headaches, sore throat, changes to sense of smell or taste
• rashes

Who is most at risk from long Covid?

As well as spotting a wider set of symptoms, the study identified certain groups as being at higher risk of developing long Covid. This includes:

• females
• younger people
• those belonging to a black, mixed or other ethnic groups

Researchers also found that people from poorer backgrounds, smokers, people who are overweight or obese, as well as the presence of a wide range of health conditions were associated with reporting persistent symptoms.

Anuradhaa Subramanian, research fellow at the Institute of Applied Health Research, University of Birmingham and lead author of the paper, said: “Our data analyses of risk factors are of particular interest because it helps us to consider what could potentially be causing or contributing to long Covid.”

She added: “Women are, for example, more likely to experience autoimmune diseases. Seeing the increased likelihood of women having long Covid in our study increases our interest in investigating whether autoimmunity or other causes may explain the increased risk in women.

“These observations will help to further narrow the focus on factors to investigate what may be causing these persistent symptoms after an infection, and how we can help patients who are experiencing them.”

When should I get help for long Covid?

Anyone who is suffering from persistent symptoms four or more weeks after having Covid is encouraged to seek advice from a GP.

A doctor may recommend some tests to find out more about the symptoms and to rule out other factors that could be causing them. This may include a blood test, checking your blood pressure and heart rate, or a chest X-ray.

You may be given advice to help manage and monitor symptoms at home, but if the effects are having a disruptive impact on your life, it is possible you may be referred to a specialist rehabilitation service, or a service that specialises in the specific symptoms you have.

More information to support your recovery can be found on the Your COVID Recovery website.