Long COVID in Hospitalized and Non-Hospitalized Patients in a Large Cohort in Northwest Spain, A Prospective Cohort Study

Abstract

Background. Survivors to COVID-19 have described long-term symptoms after acute disease. These signs constitute a heterogeneous group named long COVID or persistent COVID.Objective: The aim of this study is to describe persisting symptoms six months after COVID-19 diagnosis in a prospective cohort in the Northwest SpainDesign. This is a prospective cohort study performed in the COVID-19 Cohort of Galicia Sur Health Institute (COHVID-GS). Participants: This cohort includes patients in clinical follow-up in a health area of 569,534 inhabitants after SARS-CoV-2/COVID-19 diagnosis. Clinical and epidemiological characteristics were collected during the follow up.Main measures and key results. A total of 284 patients completed 6 months follow-up, 176 (69.4%) required hospitalization and 29 (10.2%) of them needed critical care. At six months, 119 (48.0%) patients described one or more persisting symptoms. The most prevalent were: extra-thoracic symptoms (39.1%), chest symptoms (27%), dyspnoea (20.6%), and fatigue (16.1%). These symptoms were more common in hospitalized patients (52.3% vs 38.2%) and in women (59.0% vs 40.5%). The multivariate analysis identified Chronic Obstructive Pulmonary Disease (COPD), female gender and tobacco consumption as risk factors for long COVID.Conclusions. Persisting symptoms are common after COVID-19 especially in hospitalized patients compared to outpatients (52.3% vs. 38.2%). Based on these findings, special attention and clinical follow-up after acute SARS-CoV-2 infection should be provided for hospitalized patients with previous lung diseases, tobacco consumption, and females.

Long COVID and Associated Factors in Individuals From Southern Brazil: a Population-based Study on COVID

“…Unlike the results of our study, headache as a neuropsychiatric symptom is a common persistent symptom after recovery from the acute phase of COVID-19 (44.0%) (23) , but it is more commonly found in patients who have been hospitalized (32,33) . The etiology of this type of residual symptom is complex and multifactorial and may be related to the direct effect of infection, cerebrovascular disease (including hypercoagulation) (34) , physiological impairment (hypoxia), side effects of medication and social aspects of having a potentially fatal disease (35) .…”

“…Internationally, studies nd the prevalence of long COVID to be 26.0% and 38.2% after six months (21,22) and 12.8% (6) after seven months of the acute phase of infection, with few studies investigating long COVID using a longer time frame in nonhospitalized individuals, both in the international and Brazilian literature. Regarding residual symptoms, the proportion of persistent symptoms among those infected with the mild form of acute infection may be as high as 50.0%, corroborating the data from our study (23) . Fatigue, memory loss, loss of attention, headache, loss of smell, myalgia and loss of taste were not considered the most common symptoms presented in the literature (23) .…”

“…Regarding residual symptoms, the proportion of persistent symptoms among those infected with the mild form of acute infection may be as high as 50.0%, corroborating the data from our study (23) . Fatigue, memory loss, loss of attention, headache, loss of smell, myalgia and loss of taste were not considered the most common symptoms presented in the literature (23) . Fatigue is one of the main persistent symptoms after six months of acute infection, and some authors suggest that this fact is related not only to the in ammatory response associated with acute COVID-19 infection, which may promote this prolonged convalescence but also to the possibility of posttraumatic stress disorder after COVID-19, which could contribute to a more prolonged experience of this type of symptom (24,25) .…”

Neurological complications of SARS-CoV-2 infection

“…Według obecnego stanu wiedzy wirus pozostawia ślad na wielu narządach organizmu człowieka i może powodować przetrwałe objawy. Dość popularny w środowiskach medycznych i pozamedycznych stał się termin "zespół pocovidowy", określający zespół utrzymujących się dolegliwości ze strony różnych narządów po zakażeniu SARS-CoV-2: zmęczenie, duszność, zaburzenia poznawcze, zaburzenia depresyjne/lękowe, zaburzenia węchu/smaku, bóle mięśni i stawów (Akbarialiabad et al, 2021;Carfi et al, 2020;Moreno-Pérez et al, 2021;Pérez-González et al, 2022). Według definicji National Institute for Care and Excellence (NICE) z listopada 2021 roku zespół pocovidowy to objawy i dolegliwości, które pojawiają się w trakcie zakażenia SARS-CoV-2 lub po nim, trwają ponad 12 tygodni i nie są wynikiem innych chorób (National Institute for Health and Care Excellence, 2021).…”

“…Według Światowej Organizacji Zdrowia (World Health Organization, WHO) do połowy kwietnia 2022 roku na całym świecie zachorowało ponad 500 milionów osób, z których około 6 milionów zmarło. SARS-CoV-2 to wirus wyjątkowo zakaźny, przenoszący się głównie drogą kropelkową; powoduje łagodne, przemijające objawy grypopodobne i objawy zajęcia dróg oddechowych: gorączkę, kaszel, osłabienie, bóle kostno-stawowe (Carfi et al, 2020;Mao et al, 2020;Munblit et al, 2021;Pérez-González et al, 2022). Może jednak prowadzić do ciężkiego zapalenia płuc i niewydolności oddechowej, a także do śmierci, szczególnie u osób starszych lub obciążonych dodatkowymi chorobami (Desgranges et al, 2022;Huang et al, 2020;Jha et al, 2021;Lyra e Silva et al, 2022;Ragab et al, 2020).…”