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More than 2 million adults in England have had symptoms of coronavirus lasting for more than 12 weeks, government data shows – double the previous estimate for long Covid.

The study, one of the largest to date, found that people with persistent symptoms tended to fall into two categories: those with respiratory symptoms, who often had more severe disease when they were getting sick for the first time, and a second group with fatigue-related symptoms.

Like previous studies, it found that women were affected more often and that the prevalence of persistent symptoms increased with age. The researchers described the results as “alarming”.

The React-2 study is a government-funded population surveillance study that uses finger prick antibody tests from randomly selected adults in England to assess how far the coronavirus has spread. Between September and February, 508,707 participants were also asked if they thought they had Covid and about the presence and duration of 29 different symptoms.

The research, which has not yet been peer-reviewed, found that 37.7% of those who had Covid symptoms experienced at least one symptom lasting 12 weeks or more – the equivalent of 2 million people – while 14.8% experienced three or more persistent symptoms.

“The scale of the problem is quite alarming,” said Professor Kevin McConway, professor emeritus of applied statistics at the Open University. “The results cannot tell us clearly how serious these symptoms are in terms of the effects on patients’ lives. Some may not be very serious, but some certainly are, and these results clearly show how vital it is to understand them well and to provide adequate treatment and support services to those affected.

In May, the Office National Statistics (ONS) estimated that one million people in the UK were suffering from self-reported long Covid. A key difference is that React-2 didn’t ask if people had Covid for a long time, only about ongoing symptoms. “A lot of people may not consider themselves to have long Covid, they just have mild persistent shortness of breath, or their loss of sense of taste has persisted for many, many months,” said Helen Ward, professor of public health at the University. ‘Imperial College. London, who co-led the study.

McConway said the ONS research estimated the number of people who had symptoms for at least 12 weeks on a particular date (May 2), while React-2 measured how many have already had long Covid between September and February.

Meanwhile, a separate study of 312 Norwegian patients published in Nature Medicine on Wednesday found that 61% still had persistent symptoms at six months – including 52% of 16-30 year olds. The most common symptoms reported were loss of taste and/or smell and fatigue.

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McConway said: “The lack of clarity on the exact number of people affected should not distract from the fact that the lowest estimates still show a huge amount of largely unmet need.”

The React-2 study also found that the prevalence of persistent symptoms increased with age, with a 3.5% increase in the likelihood of developing long Covid for each decade of life. Women were 1.5 times more likely to have persistent symptoms than men, and people who were overweight, who smoked, lived in deprived areas or had been hospitalized were also at higher risk. However, persistent symptoms were less common among Asian ethnic groups.

He also suggested that certain symptoms often cluster together. “About a third of the people had what you might think of as more physiological symptoms, like shortness of breath, chest tightness, chest pain, and the rest had a more fatigue-dominated type of post-viral syndrome,” said the study co-Professor Paul Elliott, chair of epidemiology and public health medicine at Imperial College. “And it turns out that the people who reported more severe illness early on, there were more in the respiratory-type cluster than in the post-viral fatigue-type cluster.”

Matt Hancock, the Health Secretary, said: “Long Covid can have a lasting and debilitating impact on the lives of those affected. Studies like this help us rapidly develop our understanding of the impact of the disease, and we use these findings and other new research to develop support and treatments.