Post-COVID-19 condition symptoms are still present in both hospitalised and non-hospitalised patients two years after their acute infection
Research by a Spanish team has revealed how symptoms of post-COVID-19 condition (i.e., long covid) persist in both hospitalised and non-hospitalised patients for at least 2 years following their acute infection with the virus.
It has become increasingly recognised that approximately 10% – 20% of people infected with COVID-19 continue to experience a variety of mid- and long-term effects after they recover from their initial illness. The World Health Organisation uses the term ‘post-COVID-19 condition’ and which refers to the constellation of long-term symptoms that some people experience after they have been infected with COVID-19. A wide range of symptoms have been reported affecting various systems in the body, some of which leading to both cognitive and sensory impairment. In fact, a 2021 scoping review identified more than 100 symptoms and whose prevalence varied significantly and were not explained by data collection approaches, study design or other methodological approaches. To date several reviews have examined post-COVID-19 condition symptoms but have only been able to report on the prevalence up to 1 year following an acute infection. In the present study, the Spanish team set out to explore and compare the presence of symptoms in both hospitalised and non-hospitalised patients after a follow-up period of two years.
Hospitalised and non-hospitalised patient data was collected and a random sample from both cohorts who were infected during the first wave of the pandemic and had not been subsequently re-infected were included. Demographic and clinical data were collected from medical records and invited participants agreed to have a scheduled telephone interview 2 years after their infection and which enquired about the presence of a range of symptoms.
Post-COVID-19 condition symptoms after 2 years
A total of 360 hospitalised patients with a mean age of 60.7 years (45% female) and 308 non-hospitalised patients (mean age = 56.7, 59.4% female) were included in the study. The hospitalised and non-hospitalised groups were assessed after a mean of 23.8 and 23.4 months respectively.
Overall, 59.7% of hospitalised and 67.5% of non-hospitalised patients reported having at least 1 post-COVID-19 condition symptom at their follow-up interview. Dyspnoea was more prevalent at the onset of illness among hospitalised compared to non-hospitalised patients (31.1% vs 11.7%, p < 0.001). In contrast, anosmia was more common among non-hospitalised individuals (21.4% vs 10.0%, p = .003).
Th most frequent condition in both cohorts was fatigue (44.7% vs 47.7%, hospitalised vs non-hospitalised), with a similar level of pain symptoms including headaches (35.8% vs 29.9%), memory loss (20% vs 15.9%) and dyspnoea at rest (3.9% both groups).
In multivariate regression analysis, among hospitalised patients, the number of pre-existing co-morbidities was significantly associated with fatigue (odds ratio, OR = 1.93, 95% CI 1.09 – 3.42, p = 0.02) and dyspnoea (OR = 1.91, 95% CI 1.04 – 3.48, p = 0.03). Among non-hospitalised patients, the number of pre-existing co-morbidities (OR = 3.75) and the number of symptoms at infection onset (OR = 3.84) were both associated with the presence of fatigue.
The authors concluded that their cross-sectional study suggested the presence of at least 1 post-COVID-19 symptom in a large proportion of infected patients and which appeared to be irrespective of disease severity.
Fernández-de-las-Peñas C et al. Post-COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients. JAMA New Open 2022