Clinical Characteristics in the Acute Phase of COVID-19 That Predict Long COVID: Tachycardia, Myalgias, Severity, and Use of Antibiotics as Main Risk Factors, While Education and Blood Group B Are Protective

Abstract

Background: Risk factors for developing long COVID are not clearly established. The present study was designed to determine if any sign, symptom, or treatment of the acute phase, or personal characteristics of the patient, is associated with the development of long COVID. Methods: A cohort study was carried out, randomly selecting symptomatic COVID-19 patients and not vaccinated. The severity of the acute illness was assessed through the number of compatible COVID-19 symptoms, hospitalizations, and the symptom severity score using a 10-point visual analog scale. Results: After multivariate analysis, a severity score ≥8 (RR 2.0, 95%CI 1.1–3.5, p = 0.022), hospitalization (RR 2.1, 95%CI 1.0–4.4, p = 0.039), myalgia (RR 1.9, 95%CI 1.08–3.6, p = 0.027), tachycardia (RR 10.4, 95%CI 2.2–47.7, p = 0.003), and use of antibiotics (RR 2.0, 95%CI 1.1–3.5, p = 0.022), was positively associated with the risk of having long COVID. Higher levels of education (RR 0.6, 95%CI 0.4–0.9, p = 0.029) and type positive B blood group (B + AB, RR 0.44, 95%CI 0.2–0.9, p = 0.044) were protective factors. The most important population attributable fractions (PAFs) for long COVID were myalgia (37%), severity score ≥8 (31%), and use of antibiotics (27%). Conclusions: Further studies in diverse populations over time are needed to expand the knowledge that could lead us to prevent and/or treat long COVID.

A retrospective cohort study on early antibiotic use in vaccinated and unvaccinated COVID‐19 patients

“…Having shown the infection of the microbiome and the replication of SARS‐CoV‐2 within it, we cannot dismiss the hypothesis of potential favourable and antiviral effects of certain NSAIDs, such as indomethacin or mefenamic acid, directly on the microbiome. Furthermore, further studies should be conducted to explore this hypothesis in depth, based on the observations made by 99,100 …”

“…The insightful research conducted by Delgado‐Enciso et al 99 sheds light on the association between antibiotic usage during the acute phase of COVID‐19 and the onset of LC (RR 2.0, 95% CI 1.1–3.5, p = 0.022). Although the study does not delve into the specific types of antibiotics used or their duration, it reveals compelling findings.…”

“…Furthermore, further studies should be conducted to explore this hypothesis in depth, based on the observations made by. 99,100 In the context of emergency vaccine and antiviral approvals during the pandemic, the ethical perspective of using antibiotics to save lives and reduce viral replication on bacterial platforms arises -especially in the early spread of the virus. The immediate administration of antibiotics at the onset of symptoms may be justified, recognizing that antibiotics are not the ultimate solution.…”

“…an increase in bacterial resistance has been correlated with wide use of intramuscular antibiotics especially in the hospitalization phases. The study shows that hospital antibiotics widely used in Taiwan were β-lactam/β-lactamase inhibitor combinations, quinolones, carbapenems, colistin, tigecycline, fosfomycin, glycopeptides, linezolid, and daptomycin, during January-June 2020 compared with January-June 2019.The insightful research conducted by Delgado-Enciso et al99 sheds light on the association between antibiotic usage during the acute phase of COVID-19 and the onset of LC (RR 2.0, 95% CI 1.1-3.5, p = 0.022).Although the study does not delve into the specific types of antibiotics used or their duration, it reveals compelling findings. Among the 311 cases examined, approximately 49.7% of individuals received antibiotics, with over half of them (54.3%) subsequently experiencing LC symptoms after a remission period averaging 4.0 + 1.3 months.…”

SARS-CoV-2 and the nervous system: current perspectives

“…The course of acute COVID-19 infection also affects the probability of developing long COVID. In particular, a severe acute illness, longer hospitalization, and ICU stay are important predictors of the occurrence of long COVID [ 105 , 107 , 109 – 111 , 113 , 114 , 116 , 117 ]. The occurrence of neurological complications, such as myalgia, tachycardia, dyspnoea, chest pain, congestion, and depression during acute infection is a predictor of long COVID [ 105 , 107 , 112 , 117 ].…”