key: cord-0751301-7h3vv91x authors: Kaatz, Martin; Springer, Steffen; Schubert, Roger; Zieger, Michael title: Representation of long COVID syndrome in the awareness of the population is revealed by Google Trends analysis date: 2022-03-26 journal: Brain Behav Immun Health DOI: 10.1016/j.bbih.2022.100455 sha: 8b44b3d787ee8e4d97ec43351551a799562dd0cc doc_id: 751301 cord_uid: 7h3vv91x In some COVID-19 patients, symptoms persist for several weeks and sometimes, after the acute disease phase, these patients develop new symptoms, which then represents a transition into the so-called long COVID. The exact demarcation of the terms and generally applicable definitions are still discussed, but the phenomenon is most commonly referred to as long COVID. In this study, Google Trends data have been used to track levels of public awareness for long COVID and some important symptoms during the course of the COVID-19 pandemic. The results of this analysis clearly demonstrate the public interest in the new topic of long COVID, as documented by a corresponding search volume. This is related to the disease COVID-19, which is being spread by the corona pandemic. Relevant symptoms for COVID-19 or long COVID, for example ageusia and anosmia, only started to receive more public attention during the pandemic. Therefore, Google Trends is a useful tool to demonstrate the population's awareness of certain infodemiological topics like long COVID. • Long COVID plays a non-negligible role in the population's information needs, as 28 evidenced by the growing search interest during the pandemic. 29 • Symptoms ageusia and anosmia became relatively well-known and relevant during 30 the pandemic. Introduction SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has spread worldwide since its 35 first known appearance in Wuhan City, Hubei province (Central China), in December 2019. The 36 resulting COVID-19 (coronavirus disease 2019) pandemic has extensive, long-term health, 37 social and economic consequences worldwide. 38 The severity of the novel disease COVID-19 ranges from asymptomatic to severe ( respective query, which is set to 100 in Google Trends for this peak. 84 In this study, data were collected with the following settings in Google Trends 85 (https://trends.google.com/trends): the period was set the "last five years", the region was 86 selected as "worldwide" and "all categories" and "web search" were set. 87 In this study, search topics were used instead of search terms for better coverage, as using 88 search topics covers a group of terms that share the same concept in every language. The 89 topics "long COVID" and "coronavirus disease 2019" were queried in comparison with the 90 following disease-related topics: "common cold", "influenza", "paediatric multisystem 91 inflammatory syndrome", and "diabetes". The following search topics were selected according to main symptom complexes (Crook et 93 al., 2021): "ageusia", "anosmia", "shortness of breath", "clouding of consciousness" (cognitive 94 impairment), and "fatigue" or "fatigue syndrome". Google Trends data were accessed in January and February 2022. As shown in Figure 1A , the relative search interest for the topic of COVID-19 dominates 99 compared to the topics of long COVID and other common diseases such as diabetes, influenza, 100 J o u r n a l P r e -p r o o f topics provide insufficient data (Fig. 1A) . The high level of public interest in the new disease 102 at the beginning of 2020 is particularly remarkable. 103 Without COVID-19 as a reference, the control topics influenza and common cold show a 104 seasonal trend, while the topic diabetes is relatively constant throughout the year (Fig. 1B) . 105 When looking at seasonal infectious diseases, differences are to be seen only in years marked 106 by the pandemic, as for example a clear decrease in the peak height of the common cold can 107 be observed (Fig. 1B) . 108 In contrast, at the beginning of 2020, the beginning of the corona pandemic, there was an In order to be able to examine the interest in long COVID and its development over time in 120 more detail, the investigation was focused on this search topic specifically. Figure 2 shows the 121 corresponding Google Trends data for the past five years. 122 The long COVID topic shows a mainly rising trajectory of public interest beginning in early 123 2020. Overall, the relative search interest in long COVID is higher than for other COVID-19-124 related conditions, such as the pediatric multi-system inflammatory syndrome (PMIS) 125 associated with COVID-19 (Zou et al., 2021) , which shows to be low in interest, apart from 126 three peaks ( Fig. 2A) . In contrast, the interest in the COVID-19-related symptoms ageusia and 127 anosmia decreases after one initial peak each ( Fig. 2A) . The topic of shortness of breath (SOB) Despite the limitations of the study, analysis of the available data shows a clear trend. 185 While interest in some relevant symptoms has declined again after an initial peak at the 186 beginning of the pandemic, long COVID shows a relatively steady increase during the 187 pandemic period under investigation, intermittently punctuated by a significant dip towards 188 the end of 2021. 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