Long Covid has more symptoms than previously thought, including hair loss and reduced sex drive, new research suggests.
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, a study found.
Patterns of symptoms tended to be grouped into respiratory symptoms, mental health and cognitive problems, and then a broader range of symptoms.
Researchers also identified key groups and behaviour that put people at increased risk of developing long Covid.
The study suggests females, younger people, and those belonging to a black, mixed or other ethnic group are at greater risk of developing the prolonged illness.
People from poorer backgrounds, smokers, those who are overweight or obese, and those with a wide range of health conditions were also associated with reporting persistent symptoms.
Senior author Dr Shamil Haroon is associate clinical professor in public health at the University of Birmingham.
“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," Dr Haroon said.
“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.”
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.
The National Health Service list of common Covid-19 symptoms includes fatigue, shortness of breath, chest pain or tightness, and brain fog.
Researchers from the University of Birmingham, alongside a team of clinicians and researchers across England, analysed anonymous electronic health records of 2.4 million people in the UK.
The data taken between January 2020 and April 2021 was from 486,149 people with prior infection, and 1.9 million people with no indication of coronavirus infection after matching for other clinical diagnoses.
Using data from patients who had not been admitted to hospital, the team of researchers were able to identify the three categories of distinct symptoms.
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“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,” said Anuradhaa Subramanian, research fellow at the Institute of Applied Health Research at the University of Birmingham and lead author of the paper.
“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.”
The findings are published in Nature Medicine.