A one-year follow-up study of systematic impact of long COVID symptoms among patients post SARS-CoV-2 omicron variants infection in Shanghai, China

Abstract

Long COVID hinders people from normal life and work, posing significant medical and economic challenges. Nevertheless, comprehensive studies assessing its impact on large populations in Asia are still lacking. We tracked over 20,000 patients infected with COVID-19 for the first time during the Omicron BA.2 outbreak in Shanghai from March-June 2022 for one year. Of the 21,799 COVID-19 patients who participated in the 6-month telephone follow-up, 1939 (8.89%) had self-reported long COVID symptoms. 450 long COVID patients participated in the 6-month outpatient follow-up. Participants underwent healthy physical examinations and questionnaires focused on long-COVID-related symptoms and mental health. Mobility problem ( P < 0.001), personal care problem ( P = 0.003), usual activity problem ( P < 0.001), pain/discomfort ( P < 0.001), anxiety/depression ( P = 0.001) and PTSD ( P = 0.001) were more prevalent in long COVID patients than in healthy individuals, but no significant differences were found between the two groups on chest CT and laboratory examinations. Of the 856 long COVID patients who participated in the 12-month follow-up, 587 (68.5%) had their symptoms resolved. In the multivariable logistic analysis, females ( P < 0.001), youth (age <40 years) ( P < 0.001), ≥ 2 comorbidities ( P = 0.009), and severe infection in the acute phase ( P = 0.006) were risk factors for developing long COVID. Middle age (40–60 years) was a risk factor for persistent long COVID one year after hospital discharge ( P = 0.013). The study found that long COVID mainly manifested as subjective symptoms and impacts partial patients’ quality of life and mental status. After one year, most (68.5%) of the patients recovered from long COVID with no impairment of organ function observed.

Long-term effects of Omicron BA.2 breakthrough infection on immunity-metabolism balance: a 6-month prospective study

“…Recovery from liver damage has also been shown to be one of the hallmarks of survival in critically ill patients 23 . The results were consistent with a previous report that ~9% of moderate-severe BA.2 infection may lead to symptomatic long COVID at six months post BA.2 infection 13 . Additionally, Age and RNAemia were reported to be the best binary signatures associated with 28-day ICU mortality 23 .…”

“…This also suggests that a balance between immunity and metabolism is required for complete recovery. Additionally, in the absence of obvious symptoms, we do not recommend using any drug to correct the immunity-metabolism imbalance as major manifestations of long COVID caused by mild BA.2 BTI were induced by abnormal mental state 13 . But coagulation disorder should be kept an eye on, and the prolactin level can be interfered with if retained too high, especially for male patients, which can not only reduce inflammation to a certain extent but also relieve related long-term complications.…”

“…However, we did not find RNAemia in our study. It might be due to infected variant and participant differences, as female, pre-existing medical conditions, and severity during acute infection were risk factors for developing long COVID 13 , 43 , 44 . It was reported that SARS-CoV-2 infection can cause lymphopenia 45 , 46 , we also found a low Lym% three months post BA.2 BTI, along with elevated neutrophil and monocyte counts.…”

“…Omicron infections result in fewer hospitalizations, less severe illness, and a higher rate of asymptomatic cases, making it challenging to evaluate the related long COVID 10 – 12 . A recently published study showed that approximately 70% of Omicron BA.2 related long COVID will recover in one year after infection 13 . However, little is known about its mechanism and possible hidden pathological features.…”

Quantifying the Adverse Effects of Long COVID on Individuals’ Health After Infection: A Propensity Score Matching Design Study

“…One study showed that the prevalence of long COVID was between 10% and 15%, 24 and a previous study from China showed that 8.89% of infected individuals self-reported long COVID symptoms, 25 which is basically consistent with the results of our study (9.73%). However, other studies have reported different prevalence rates.…”