Elsevier

Journal of Infection

Volume 84, Issue 4, April 2022, Pages 566-572
Journal of Infection

Determinants of persistence of symptoms and impact on physical and mental wellbeing in Long COVID: A prospective cohort study

https://doi.org/10.1016/j.jinf.2022.02.003Get rights and content
Under a Creative Commons license
open access

Highlights

  • Advanced age, ICU admission and multiple symptoms at onset are predictors of Long COVID among patients with SARS-CoV-2 infection.

  • Female gender and persistence of symptoms at day 28 and month 9 were risk factors for psychological distress.

  • Prolonged symptoms have negative impact on both physical and mental wellbeing.

  • Studies on Long COVID determinants and consequences are encouraged to identify target populations for recovery interventions.

Summary

Background

Residual symptoms can be detected for several months after COVID-19. To better understand the predictors and impact of symptom persistence we analyzed a prospective cohort of COVID-19 patients.

Methods

Patients were followed for 9 months after COVID-19 onset. Duration and predictors of persistence of symptoms, physical health and psychological distress were assessed.

Results

465 patients (54% males, 51% hospitalized) were included; 37% presented with at least 4 symptoms and 42% complained of symptom lasting more than 28 days. At month 9, 20% of patients were still symptomatic, showing mainly fatigue (11%) and breathlessness (8%). Hospitalization and ICU stay vs. non-hospitalized status increased the median duration of fatigue of 8 weeks. Age > 50 years (OR 2.50), ICU stay (OR 2.35), and presentation with 4 or more symptoms (OR 2.04) were independent predictors of persistence of symptoms at month 9. A total of 18% of patients did not return to optimal pre-COVID physical health, while 19% showed psychological distress at month 9. Hospital admission (OR 2.28) and persistence of symptoms at day 28 (OR 2.21) and month 9 (OR 5.16) were independent predictors of suboptimal physical health, while female gender (OR 5.27) and persistence of symptoms at day 28 (OR 2.42) and month 9 (OR 2.48) were risk factors for psychological distress.

Conclusions

Patients with advanced age, ICU stay and multiple symptoms at onset were more likely to suffer from long-term symptoms, which had a negative impact on both physical and mental wellbeing. This study contributes to identify the target populations and Long COVID consequences for planning long-term recovery interventions.

Keywords

COVID-19
Long COVID
Predictors
Symptom persistence
Psychological distress
Physical health

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These authors contributed equally to this work.