Long-COVID Clinical Features and Risk Factors: A Retrospective Analysis of Patients from the STOP-COVID Registry of the PoLoCOV Study

Chudzik, Michał; Babicki, Mateusz; Kapusta, Joanna; Kałuzińska, Żaneta; Kołat, Damian; Jankowski, Piotr; Mastalerz-Migas, Agnieszka

doi:10.3390/v14081755

Cited by 38 publications

(51 citation statements)

References 31 publications

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“…Consistently with the open literature, in the present study, the main symptoms experienced by patients at the second follow up were shortage of breath, fatigue, anosmia, and ageusia [ 7 , 20 , 28 , 30 , 35 , 36 , 37 ].…”

Section: Discussionsupporting

confidence: 91%

Persistence of Symptoms 15 Months since COVID-19 Diagnosis: Prevalence, Risk Factors and Residual Work Ability

Sansone

Tassinari

Valentinotti³

et al. 2022

Life

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Background: A proportion of patients’ ailments may last after recovering from acute COVID-19, with episodic and systemic symptoms of unclear etiology potentially involving different organs. Study aim: The aim of this study was to investigate the persistence of symptoms 15 months since COVID-19 diagnosis in patients referring to the post-COVID-19 clinic in Trieste (north-eastern Italy). Methods: Two-hundred-forty-seven patients were medically examined between 8 December 2020–6 April 2021, after a median time of 49 days since first positive swab test for SARS-CoV-2. After a median time of 15 months since COVID-19 diagnosis, the same patients were contacted over the phone and investigated by standardized questionnaire collecting information on any persisting symptoms and work ability index (WAI). Four multivariable logistic regression models were fitted to investigate factors associated with persistence of any respiratory, neurological, dysautonomic, or psychiatric symptoms at first (median time 49 days since COVID-19 diagnosis) as well as second (median 15 months since COVID-19 diagnosis) follow up. A multiple linear regression was also employed to investigate factors associated with higher mean WAI, assessed only at second follow up. Additionally, factors associated with persistence of symptoms 200+ days since COVID-19 diagnosis between first and second follow-up were investigated by multivariable Generalized Estimating Equation (GEE). Results: At first follow up (median time of 49 days since COVID-19 diagnosis) symptoms more frequently reported were fatigue (80.2%), shortness of breath (69.6%), concentration deficit (44.9%), headache (44.9%), myalgia (44.1%), arthralgia (43.3%), and anosmia (42.1%). At second follow-up (median time of 15 months since COVID-19 diagnosis) 75% patients returned to their baseline status preceding COVID-19. At first follow up males were less likely to experience neurological (OR = 0.16; 95% CI: 0.08; 0.35) as well as psychiatric (OR = 0.43; 95% CI: 0.23; 0.80) symptoms as compared to females. At first follow up, the risk of neurological symptoms increased also linearly with age (OR = 1.04; 95% CI: 1.01; 1.08) and pre-existing depression was a major risk factor for persisting dysautonomic (aOR = 6.35; 95% CI: 2.01; 20.11) as well as psychiatric symptoms (omitted estimate). Consistently, at second follow up only females experience psychiatric symptoms, whereas males exhibited significantly higher mean WAI (RC = 0.50; 95% CI: 0.11; 0.88). Additionally, neurological symptoms at second follow up were more likely in patients with pre-existing comorbidities (OR = 4.31; 95% CI: 1.27; 14.7). Finally, persistence of symptoms lasting 200+ days since COVID-19 diagnosis increased linearly with age (OR = 1.03; 95% CI 1.01–1.05) and were more likely in patients affected by pre-existing depression (OR = 2.68; 95% CI 1.60; 4.49). Conclusions: Following a median time of 15 months since first positive swab test, 75% patients with symptoms returned to their baseline health status preceding COVID-19. Females had a significantly lower WAI and were more likely to experience psychiatric symptoms at second follow up (15 months since COVID-19 diagnosis). Furthermore, the risk of symptoms persisting 200+ days since COVID-19 diagnosis increased with history of depression, endorsing the hypothesis that long-COVID-19 symptoms may be at least partially explained by pre-existing psychological conditions. Patient rehabilitation and psychological support may therefore play a key role in caring patients with the so called long COVID-19 syndrome.

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Section: Discussionsupporting

confidence: 91%

Persistence of Symptoms 15 Months since COVID-19 Diagnosis: Prevalence, Risk Factors and Residual Work Ability

Sansone

Tassinari

Valentinotti³

et al. 2022

Life

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“…The PRISMA flowchart for study selection is available in eFigure 1 in Supplement 1. The Table summarizes the population cohorts and the study design characteristics of all the included studies . Of the 41 observational studies, 30 were ranked as high quality and 11 moderate quality on the Newcastle-Ottawa Scale (eTable 1 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

Risk Factors Associated With Post−COVID-19 Condition

et al. 2023

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ImportancePost−COVID-19 condition (PCC) is a complex heterogeneous disorder that has affected the lives of millions of people globally. Identification of potential risk factors to better understand who is at risk of developing PCC is important because it would allow for early and appropriate clinical support.ObjectiveTo evaluate the demographic characteristics and comorbidities that have been found to be associated with an increased risk of developing PCC.Data sourcesMedline and Embase databases were systematically searched from inception to December 5, 2022.Study SelectionThe meta-analysis included all published studies that investigated the risk factors and/or predictors of PCC in adult (≥18 years) patients.Data Extraction and SynthesisOdds ratios (ORs) for each risk factor were pooled from the selected studies. For each potential risk factor, the random-effects model was used to compare the risk of developing PCC between individuals with and without the risk factor. Data analyses were performed from December 5, 2022, to February 10, 2023.Main Outcomes and MeasuresThe risk factors for PCC included patient age; sex; body mass index, calculated as weight in kilograms divided by height in meters squared; smoking status; comorbidities, including anxiety and/or depression, asthma, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, immunosuppression, and ischemic heart disease; previous hospitalization or ICU (intensive care unit) admission with COVID-19; and previous vaccination against COVID-19.ResultsThe initial search yielded 5334 records of which 255 articles underwent full-text evaluation, which identified 41 articles and a total of 860 783 patients that were included. The findings of the meta-analysis showed that female sex (OR, 1.56; 95% CI, 1.41-1.73), age (OR, 1.21; 95% CI, 1.11-1.33), high BMI (OR, 1.15; 95% CI, 1.08-1.23), and smoking (OR, 1.10; 95% CI, 1.07-1.13) were associated with an increased risk of developing PCC. In addition, the presence of comorbidities and previous hospitalization or ICU admission were found to be associated with high risk of PCC (OR, 2.48; 95% CI, 1.97-3.13 and OR, 2.37; 95% CI, 2.18-2.56, respectively). Patients who had been vaccinated against COVID-19 with 2 doses had a significantly lower risk of developing PCC compared with patients who were not vaccinated (OR, 0.57; 95% CI, 0.43-0.76).Conclusions and RelevanceThis systematic review and meta-analysis demonstrated that certain demographic characteristics (eg, age and sex), comorbidities, and severe COVID-19 were associated with an increased risk of PCC, whereas vaccination had a protective role against developing PCC sequelae. These findings may enable a better understanding of who may develop PCC and provide additional evidence for the benefits of vaccination.Trial RegistrationPROSPERO Identifier: CRD42022381002

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Section: Discussionmentioning

confidence: 99%

“…Among the reported risk factors of developing long COVID, such as older age, female sex, and underlying comorbidities [3] , [4] , the severity of the acute infection is substantial [31] , [32] . Several studies reported that the disease severity correlated with the frequency and duration of sequelae [31] , [32] , [33] . According to a multicenter retrospective study, hospitalized and ICU-admitted patients were three and five times more likely to have long COVID, respectively [31] .…”

Section: Discussionmentioning

confidence: 99%

Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis

Watanabe

Iwagami

Yasuhara

et al. 2023

Vaccine

130

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Long-COVID Clinical Features and Risk Factors: A Retrospective Analysis of Patients from the STOP-COVID Registry of the PoLoCOV Study

Cited by 38 publications

References 31 publications

Persistence of Symptoms 15 Months since COVID-19 Diagnosis: Prevalence, Risk Factors and Residual Work Ability

Persistence of Symptoms 15 Months since COVID-19 Diagnosis: Prevalence, Risk Factors and Residual Work Ability

Risk Factors Associated With Post−COVID-19 Condition

Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis

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