Post-COVID-19 Symptom Burden: What is Long-COVID and How Should We Manage It?

Abstract

The enduring impact of COVID-19 on patients has been examined in recent studies, leading to the description of Long-COVID. We report the lasting symptom burden of COVID-19 patients from the first wave of the pandemic. All patients with COVID-19 pneumonia discharged from a large teaching hospital trust were offered follow-up. We assessed symptom burden at follow-up using a standardised data collection technique during virtual outpatient clinic appointments. Eighty-six percent of patients reported at least one residual symptom at follow-up. No patients had persistent radiographic abnormalities. The presence of symptoms at follow-up was not associated with the severity of the acute COVID-19 illness. Females were significantly more likely to report residual symptoms including anxiety (p = 0.001), fatigue (p = 0.004), and myalgia (p = 0.022). The presence of long-lasting symptoms is common in COVID-19 patients. We suggest that the phenomenon of Long-COVID may not be directly attributable to the effect of SARS-CoV-2, and believe the biopsychosocial effects of COVID-19 may play a greater role in its aetiology.

Keywords: COVID-19; Long-COVID; Symptom burden.

Fig. 1

a Cluster bar chart showing symptoms by sex. b A cluster bar chart showing symptom burden by time to follow-up. Asterisk denotes p-value on Chi-Square testing of < 0.05, double asterisk denotes p-value on Chi-Square testing of < 0.001

Fig. 2

Co-occurrence matrix, displaying both the frequency and the correlation coefficient of two co-occurring symptoms. Asterisk denotes correlation coefficient as calculated using regression analysis