Incidence and risk factors for persistent symptoms in adults previously hospitalized for COVID‐19

Abstract

Background The long‐term sequalae of COVID‐19 remain poorly characterized. We assessed persistent symptoms in previously hospitalized patients with COVID‐19 and assessed potential risk factors. Methods Data were collected from patients discharged from 4 hospitals in Moscow, Russia between 8 April and 10 July 2020. Participants were interviewed via telephone using an ISARIC Long‐term Follow‐up Study questionnaire. Results 2,649 of 4755 (56%) discharged patients were successfully evaluated, at median 218 (IQR 200, 236) days post‐discharge. COVID‐19 diagnosis was clinical in 1291 and molecular in 1358. Most cases were mild, but 902 (34%) required supplemental oxygen and 68 (2.6%) needed ventilatory support. Median age was 56 years (IQR 46, 66) and 1,353 (51.1%) were women. Persistent symptoms were reported by 1247 (47.1%) participants, with fatigue (21.2%), shortness of breath (14.5%) and forgetfulness (9.1%) the most common symptoms and chronic fatigue (25%) and respiratory (17.2%) the most common symptom categories. Female sex was associated with any persistent symptom category OR 1.83 (95% CI 1.55 to 2.17) with association being strongest for dermatological (3.26, 2.36 to 4.57) symptoms. Asthma and chronic pulmonary disease were not associated with persistent symptoms overall, but asthma was associated with neurological (1.95, 1.25 to 2.98) and mood and behavioural changes (2.02, 1.24 to 3.18), and chronic pulmonary disease was associated with chronic fatigue (1.68, 1.21 to 2.32). Conclusions Almost half of adults admitted to hospital due to COVID‐19 reported persistent symptoms 6 to 8 months after discharge. Fatigue and respiratory symptoms were most common, and female sex was associated with persistent symptoms.

Studying the post-COVID-19 condition: research challenges, strategies, and importance of Core Outcome Set development

“…Long-term health consequences of COVID-19 remain unknown, but reports suggest that prolonged symptom duration and limitations in functioning are common among hospitalised as well as non-hospitalised adults [13,14] and children [15,16]. The spectrum of longlasting symptoms is wide and varies from mild discomfort to severe adverse effects on physical, cognitive, and psychosocial health [17], with important wider implications on functioning, including employment and school attendance.…”

“…Multiple studies from different countries found that many individuals experienced persistent symptoms 6 months after COVID-19, with fatigue or muscle weakness, sleep difficulties, and anxiety or depression among the most common sequelae [13,14,18]. A recent study suggests that although most COVID-19 survivors recover both physically and functionally a year after acute infection, some still experience problems with mobility, pain or discomfort, and anxiety or depression compared with non-COVID-19 controls [19].…”

Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study

“…It should be noted that most studies included samples with <500 participants, were conducted in one single center, included follow-up periods shorter than 12 weeks and did not specifically focus on sex differences [15][16][17][18][19][20][21][22][23][24][25]. Three recent multicenter studies have been published [26][27][28]. Sigfrid et al included 327 hospitalized COVID-19 survivors from five hospitals and reported that females younger than 50 years were two times more likely to report fatigue and seven times more likely to report dyspnea than men of the same age seven months after hospital discharge [26].…”

“…Sigfrid et al included 327 hospitalized COVID-19 survivors from five hospitals and reported that females younger than 50 years were two times more likely to report fatigue and seven times more likely to report dyspnea than men of the same age seven months after hospital discharge [26]. Munblit et al included 2649 COVID-19 survivors from four different hospitals and found that female sex was associated with persistent post-COVID symptoms, particularly dermatological changes, seven months after hospitalization [27]. Zhang et al included 2433 hospitalized COVID-19 survivors from two centers and reported that female sex was associated with a higher risk of post-COVID fatigue [28].…”

Long covid in children and adolescents

“…Firstly, what are the risk factors for developing long covid? Although some studies in adults have suggested that severity of the initial infection, hospital admission, female sex, white ethnicity, middle age, and asthma are risk factors for persistent symptoms,121011 the most recent and comprehensive meta-analysis concluded that data were insufficient to determine the influence of these factors 3. Secondly, what are the molecular, immunological, and psychological mechanisms underlying long covid?…”