Determinants of post-COVID-19 symptoms among adults aged 55 or above with chronic conditions in primary care: data from a prospective cohort in Hong Kong

Abstract

BackgroundPrimary care patients, especially those with an older age, are one of the most vulnerable populations for post-COVID-19 symptoms. Identifying predictors of post-COVID symptoms can help identify high-risk individuals for preventive care.MethodsOut of 977 primary care patients aged 55 years or above with comorbid physical and psychosocial conditions in a prospective cohort in Hong Kong, 207 patients infected in the previous 5–24 weeks were included. The three most common post-COVID-19 symptoms (breathlessness, fatigue, cognitive difficulty), which lasted beyond the 4-week acute infection period, were assessed using items from the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), together with other self-reported symptoms. Multivariable analyses were conducted to identify predictors of post-acute and long COVID-19 symptoms (5–24 weeks after infection).ResultsThe 207 participants had a mean age of 70.8 ± 5.7 years, 76.3% were female, and 78.7% had ≥2 chronic conditions. In total, 81.2% reported at least one post-COVID symptom (mean: 1.9 ± 1.3); 60.9, 56.5 and 30.0% reported fatigue, cognitive difficulty, and breathlessness respectively; 46.1% reported at least one other new symptom (such as other respiratory-related symptoms (14.0%), insomnia or poor sleep quality (14.0%), and ear/nose/throat symptoms (e.g., sore throat) (10.1%), etc.). Depression predicted post-COVID-19 fatigue. The female sex predicted cognitive difficulty. Receiving fewer vaccine doses (2 doses vs. 3 doses) was associated with breathlessness. Anxiety predicted a higher overall symptom severity level of the three common symptoms.ConclusionDepression, the female sex, and fewer vaccine doses predicted post-COVID symptoms. Promoting vaccination and providing intervention to those at high-risk for post-COVID symptoms are warranted.

Significant burden of post-COVID exertional dyspnoea in a South-Italy region: knowledge of risk factors might prevent further critical overload on the healthcare system

“…Rather, optimal care organization requires a personalized fashion, thus addressing different dyspnoea manifestations, severity degrees, and eventual co-morbid conditions (4,6,15). In this framework, it could be reasonable to think that PCED mainly develops in people with older age, with pre-existing respiratory conditions, or with acute-phase hospitalization courses (37)(38)(39). Although self-reported PCED was more frequent in patients with pre-COVID-19 respiratory co-morbidities in this cohort, our results suggest that a notable portion (57/190, 30.0%) of PCED-reporting patients were relatively young (under 50 yrs), most of whom were never admitted but remained at home and had an unremarkable medical history for pre-COVID-19 respiratory diseases (82.6%).…”

Psychometric analysis of the modified COVID-19 Yorkshire Rehabilitation Scale (C19-YRSm) in a prospective multicentre study

“…Open access to capture the symptoms of LC, as well as assess severity and monitor the persistence of symptoms to inform and guide the rehabilitation of affected patients. [7][8][9][10] Since the initial validation of the instrument, 7 11 it has been widely used in a variety of LC contexts including symptom evaluation in primary care and community settings, [12][13][14] determining the need for LC rehabilitation interventions, 8 9 15 as well as epidemiological assessments of post-COVID symptoms. 16 17 The original 22-item C19-YRS underwent psychometric evaluation including both classical and modern psychometric evaluation methods, resulting in a 17-item modified tool, the C19-YRSm.…”

“…The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a condition-specific patient-reported outcome measure designed to capture the symptoms of LC, as well as assess severity and monitor the persistence of symptoms to inform and guide the rehabilitation of affected patients 7–10. Since the initial validation of the instrument,7 11 it has been widely used in a variety of LC contexts including symptom evaluation in primary care and community settings,12–14 determining the need for LC rehabilitation interventions,8 9 15 as well as epidemiological assessments of post-COVID symptoms 16 17…”

The context of COVID-19 affected the long-term sleep quality of older adults more than SARS-CoV-2 infection

“…Remarkably, older age was one of the strongest predictors of symptom persistence in this cohort. Nonetheless, concerning older patients, few studies have specifically investigated whether sleep might be persistently disturbed long after COVID infection ( 26 ). Hence, this study aims to understand whether older individuals have long-term impacts on sleep quality after COVID-19 infection and which factors may influence this outcome.…”