Post-COVID-19 symptoms 6 months after acute infection among hospitalized and non-hospitalized patients

Abstract

Objectives To assess the prevalence of and factors associated with Post-Coronavirus Disease 2019 (COVID-19) syndrome six months after the onset. Methods A bidirectional prospective study. Interviews investigated symptoms potentially associated with COVID-19 six months after the disease onset of all consecutive adult in- and out-patients with COVID-19 attending Udine Hospital (Italy) from March to May 2020. IgG antibodies against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) were also evaluated six months after the onset of symptoms, at the time of the interview. Results A total of 599 individuals were included (320 female, 53.4%; mean age 53 years, SD 15.8) and interviewed 187 days (22 SD) after the onset. The prevalence of post-COVID-19 syndrome was 40.2% (241/599). The presence of IgG antibodies was significantly associated with the occurrence of post-COVID-19 syndrome (OR 2.56, 95% CI 1.48–4.38, p = 0.001) and median SARS-CoV-2 IgG titres were significantly higher in long-haulers than in patients without symptoms (42.1, IQR 17.1-78.4 vs. 29.1, IQR 12.1-54.2 kAU/L, p = 0.004). Female gender (OR 1.55, 95% CI 1.05–2.27), a proportional increase in the number of symptoms at the onset of COVID-19 (OR 1.81, 95% CI 1.59–2.05) and ICU admission OR 3.10, 95% CI 1.18–8.11) were all independent risk factors for post-COVID-19 syndrome. The same predictors also emerged in a subgroup of 231 patients with the serological follow-up available at the time of the interview alongside the proportional increase in anti-SARS-CoV-2 IgG (OR 1.01, 95% CI 1.00–1.02, p = 0.04). Conclusions Prospective follow-up could be offered to specific subgroups of COVID-10 patients, to identify typical symptoms and persistently high anti-SARS-CoV-2 IgG titers as a means of early detection of post-COVID-19 long-term sequelae.

Risk factors for long COVID: analyses of 10 longitudinal studies and electronic health records in the UK

“…Findings for overweight/obesity were suggestive of an increased risk, again helping to resolve some previous uncertainty. 4,17,20,25 No other cardiometabolic risk factors were clearly associated, consistent with past studies. 4,20,23,25…”

“…4,17,20,25 No other cardiometabolic risk factors were clearly associated, consistent with past studies. 4,20,23,25…”

“…A greater risk of long COVID related to adverse prior mental health, has been reported elsewhere, 23 but pre-pandemic general health has not previously been highlighted as a risk factor. 17,20,24 Excess risk of long COVID in association with asthma across cohorts and primary care records resolves conflicting and limited findings, 4,17,23 and supports a focus on asthma as a high-risk condition, for example by investigating whether immune processes involved in asthma or respiratory complications influence long COVID development. Findings for overweight/obesity were suggestive of an increased risk, again helping to resolve some previous uncertainty.…”

SARS-CoV-2 immunity and functional recovery of COVID-19 patients 1-year after infection

“…In this study, we define COVID-19-related symptoms as those only appeared after or shortly before the onset of COVID-19 and found about 30% participants still experiencing at least one of them at 1-year post-infection, which is in line with large surveys from Germany (34.8% prevalence at 7-month, n = 958) and Italy (40.2% at 6-month, n = 599). 41 , 42 Our finding of 79% participants with severe COVID-19 still reporting symptoms at 1-year post-infection is also reminiscent of the follow-up study of patients treated at Jin Yin-tan Hospital in Wuhan City (76% at 6-month, n = 1,733). 11 It is known that COVID-19 could have neurological and psychiatric manifestation, 43 , 44 and we suspect that some symptoms not associated with any serological indications or functional recovery status could be the result of stress or even PTSD-like psychiatric disorders as suggested in a survey of COVID-19 patients in the UK.…”

Morphologische und funktionelle Folgen nach COVID-19-Pneumonie

“…Das Risiko, ein Long COVID-Syndrom zu entwickeln, scheint von mehreren Faktoren abhängig zu sein, wobei in der aktuellen Literatur kontroverse Aussagen zu finden sind. Als Risikofaktoren werden der Schweregrad der akuten Erkrankung, höheres Alter, weibliches Geschlecht und ein höherer Body-Mass-Index (BMI) diskutiert [27,32]. [14,19].…”