Predictors of Long COVID in Patients without Comorbidities: Data from the Polish Long-COVID Cardiovascular (PoLoCOV-CVD) Study

Abstract

Background: The SARS-CoV-2 pandemic has become an enormous worldwide challenge over the last two years. However, little is still known about the risk of Long COVID (LC) in patients without comorbidities. Thus, we aimed to assess the predictors of LC in patients without comorbidities. Methods: Patients’ information, the course of the disease with symptoms, and post-COVID-19 complaints were collected within 4–12 weeks after COVID-19 recovery. Next, the patients were followed for at least 3 months. ECG, 24-h ECG monitoring, 24-h blood pressure (BP) monitoring, echocardiography, and selected biochemical tests were performed. LC was recognized based on the WHO definition. Results: We identified 701 consecutive patients, 488 of whom completed a 3-month follow-up (63% women). Comparisons were made between the LC group (n = 218) and patients without any symptoms after SARS-CoV-2 recovery (non-LC group) (n = 270). Patients with a severe course of acute-phase COVID-19 developed LC complications more often (34% vs. 19%, p < 0.0001). The persistent symptoms were observed in 45% of LC patients. The LC group also had significantly more symptoms during the acute phase of COVID-19, and they suffered significantly more often from dyspnoea (48 vs. 33%), fatigue (72 vs. 63%), chest pain (50 vs. 36%), leg muscle pain (41 vs. 32%), headache (66 vs. 52%), arthralgia (44 vs. 25%), and chills (34 vs. 25%). In LC patients, significant differences regarding sex and body mass index were observed—woman: 69% vs. 56% (p = 0.003), and BMI: 28 [24–31] vs. 26 kg/m2 [23–30] (p < 0.001), respectively. The number of symptoms in the acute phase was significantly greater in the LC group than in the control group (5 [2–8] vs. 2 [1–5], p = 0.0001). The LC group also had a higher 24-h heart rate (77 [72–83] vs. 75 [70–81], p = 0.021) at admission to the outpatient clinic. Multivariate regression analysis showed that LC patients had a higher BMI (odds ratio (OR): 1.06, 95% confidence intervals [CI]: 1.02–1.10, p = 0.007), almost twice as often had a severe course of COVID-19 (OR: 1.74, CI: 1.07–2.81, p = 0.025), and presented with joint pain in the acute phase (OR: 1.90, CI: 1.23–2.95, p = 0.004). Conclusions: A severe course of COVID-19, BMI, and arthralgia are independently associated with the risk of Long COVID in healthy individuals.

Long COVID in Uganda: Electrographic findings among patients at risk

“…This study in Uganda suggests that ECG abnormalities were lower among females, which differs from findings from a cohort study in China [4]. More females than males presented with symptoms of Long COVID which included chest pain, difficulty in breathing, and palpitations that are hallmarks of CVDs [3]. This could have prompted individuals to seek care at post COVID‐19 clinic leading to the initiation of treatment arresting the progression of the sequalae.…”

“…Similar to a Polish Long COVID cardiovascular study [3], most of the participants in this Uganda study presented with complaints of fatigue, chest pain, difficulty in breathing, and palpitation which would warrant further CVD assessment which include ECG to rule out myocardial infarctions, life threatening arrhythmias, or any conduction abnormality. Coincidentally, 13% of the participants were found to have ischemic ECG features, whereas 34.8% of them had nonspecific T‐wave invasion.…”

“…COVID‐19 is a multisystemic disease [2] with cardiovascular system complications. This may persist even after recovery resulting into symptoms of Long COVID [3]. A high proportion of people at risk of Long COVID developed cardiovascular diseases (CVDs) [4], especially during the convalescent phase [5].…”

Factors of Persistent Limited Exercise Tolerance in Patients after COVID-19 with Normal Left Ventricular Ejection Fraction

“…Pelà et al demonstrated that females were more symptomatic than males, not only in the acute phase but also at follow-up [ 33 ]. In another research study, the authors evaluated the predictors of Long-COVID in patients without comorbidities and observed significant differences relating to sex between women with Long-COVID and women without any symptoms after SARS-CoV-2 recovery [ 34 ]. However, there have been no studies until now accessing objectively exercise tolerance after COVID-19.…”

Course of fatigue among patients previously hospitalised due to COVID-19

“…Fatigue represents the most common post-acute sequelae of Coronavirus Disease 2019 (COVID-19) [1,2]. Its prevalence in the acute phase of infection is estimated at more than 60% [3], even among patients who eventually do not develop long COVID syndrome [4]. As shown recently, irrespective of initial improvement, most individuals with a Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection will suffer from fatigue within three months following the onset of disease [5].…”