Post-COVID-19 syndrome risk factors and further use of health services in East England

Abstract

Post-COVID syndrome, defined as symptoms persisting for more than twelve weeks after the diagnosis of COVID-19, has been recognised as a new clinical entity in the context of SARS-CoV-2 infection. This study was conducted to characterise the burden and predictors for post-COVID-19 syndrome in the local population. It was a community-based web-survey study conducted in Norfolk, East England, UK. We sent the survey to patients with confirmed COVID-19 infection by real-time polymerase chain reaction by December 6th, 2020. Questions related to the pre-COVID and post-COVID level of symptoms and further healthcare use. Baseline characteristics were collected from the primary care records. Logistic regression analysis was conducted to establish predictors for post-COVID-19 syndrome and further healthcare utilisation. Of 6,318 patients, survey responses were obtained from 1,487 participants (23.5%). Post-COVID-19 syndrome symptoms were experienced by 774 (52.1%) respondents. Male sex compared to female sex was a factor protective of post-COVID symptoms; relative risk (RR) 0.748, 95% confidence interval (CI), 0.605–0.924. Body mass index was associated with a greater risk of developing post-COVID-19 symptoms (RR 1.031, 95% CI, 1.016–1.047, for 1 kg/m2). A total of 378 (25.4%) people used further health services after their index COVID-19 infection, of whom 277 (73.2%) had post-COVID symptoms. Male sex was negatively associated with the use of further health services (RR 0.618, 95% CI, 0.464–0.818) whereas BMI was positively associated (RR 1.027, 95% CI, 1.009–1.046). Overall, post-COVID-19 symptoms increased the probability of using health services with RR 3.280, 95% CI, 2.540–4.262. This survey of a large number of people previously diagnosed with COVID-19 across East England shows a high prevalence of self-reported post-COVID-19 syndrome. Female sex and BMI were associated with an increased risk of post-COVID-19 syndrome and further utilisation of healthcare.

Two-Year Longitudinal Study Reveals That Long COVID Symptoms Peak and Quality of Life Nadirs at 6–12 Months Postinfection

“…We report that 6% of participants still had long COVID at 24 months’ follow-up, which if true in the general population, means that millions of people globally who acquired SARS-CoV-2 infection in 2020 may still be experiencing long COVID 2 years or more after infection. Other studies have reported associations of long COVID with obesity [ 28–30 ] and hyperlipidemia [ 31 ], which we observe as well. We did not observe a relationship between sex assigned at birth and long COVID, as described in other studies [ 1 , 28 , 29 , 32 ], which may be due to sample size.…”

Risk Factors Associated With Post−COVID-19 Condition

“…The PRISMA flowchart for study selection is available in eFigure 1 in Supplement 1. The Table summarizes the population cohorts and the study design characteristics of all the included studies . Of the 41 observational studies, 30 were ranked as high quality and 11 moderate quality on the Newcastle-Ottawa Scale (eTable 1 in Supplement 1).…”

Oxidative Stress is a shared characteristic of ME/CFS and Long COVID

“…No differences in ROS levels are found between males with ME/CFS or LC, compared to control males (Figure 1E, bottom row) (males ME/CFS v. HC: CD19 B cells p = 0.357, CD4 T cells p = 0.469, CD8 T cells p = 0.516; males ME/CFS v. LC: CD19 B cells p = 0.278, CD4 T cells p = 0.643, CD8 T cells p = 0.583). Notably, our data offers one potential way to interpret several epidemiological studies 31-34 that compare post-COVID 19 and ME/CFS symptoms incidence between males and females. These studies estimate that ME/CFS is three to four times more common in women than men 31 , with significantly higher likelihood for females to develop post COVID-19 symptoms 32-34 (e.g., 3.3x odds ratio estimate for LC in females v. males in Ref.…”

“…Notably, our data offers one potential way to interpret several epidemiological studies 31-34 that compare post-COVID 19 and ME/CFS symptoms incidence between males and females. These studies estimate that ME/CFS is three to four times more common in women than men 31 , with significantly higher likelihood for females to develop post COVID-19 symptoms 32-34 (e.g., 3.3x odds ratio estimate for LC in females v. males in Ref. 32).…”