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. 2022 Apr;84(4):566-572.
doi: 10.1016/j.jinf.2022.02.003. Epub 2022 Feb 10.

Determinants of persistence of symptoms and impact on physical and mental wellbeing in Long COVID: A prospective cohort study

Elda Righi  1 , Massimo Mirandola  2 , Fulvia Mazzaferri  2 , Giuditta Dossi  2 , Elisa Razzaboni  2 , Amina Zaffagnini  2 , Federico Ivaldi  2 , Alessandro Visentin  2 , Lorenza Lambertenghi  2 , Cinzia Arena  3 , Claudio Micheletto  3 , Davide Gibellini  4 , Evelina Tacconelli  2
Affiliations

Determinants of persistence of symptoms and impact on physical and mental wellbeing in Long COVID: A prospective cohort study

Elda Righi et al. J Infect. 2022 Apr.

Abstract

Background: Residual symptoms can be detected for several months after COVID-19. To better understand the predictors and impact of symptom persistence we analyzed a prospective cohort of COVID-19 patients.

Methods: Patients were followed for 9 months after COVID-19 onset. Duration and predictors of persistence of symptoms, physical health and psychological distress were assessed.

Results: 465 patients (54% males, 51% hospitalized) were included; 37% presented with at least 4 symptoms and 42% complained of symptom lasting more than 28 days. At month 9, 20% of patients were still symptomatic, showing mainly fatigue (11%) and breathlessness (8%). Hospitalization and ICU stay vs. non-hospitalized status increased the median duration of fatigue of 8 weeks. Age > 50 years (OR 2.50), ICU stay (OR 2.35), and presentation with 4 or more symptoms (OR 2.04) were independent predictors of persistence of symptoms at month 9. A total of 18% of patients did not return to optimal pre-COVID physical health, while 19% showed psychological distress at month 9. Hospital admission (OR 2.28) and persistence of symptoms at day 28 (OR 2.21) and month 9 (OR 5.16) were independent predictors of suboptimal physical health, while female gender (OR 5.27) and persistence of symptoms at day 28 (OR 2.42) and month 9 (OR 2.48) were risk factors for psychological distress.

Conclusions: Patients with advanced age, ICU stay and multiple symptoms at onset were more likely to suffer from long-term symptoms, which had a negative impact on both physical and mental wellbeing. This study contributes to identify the target populations and Long COVID consequences for planning long-term recovery interventions.

Keywords: COVID-19; Long COVID; Physical health; Predictors; Psychological distress; Symptom persistence.

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Conflict of interest statement

Declaration of Competing Interest The authors have no competing interests

Figures

Fig 1
Fig. 1
Frequency of the most common SARS-CoV-2-related symptoms.
Fig 2
Fig. 2
Kaplan Maier curves reporting duration of symptoms among COVID-19 patients.
Fig 3
Fig. 3
Kaplan-Meier curves reporting the association between hospitalization and ICU admission with fatigue persistence at 9-month follow-up.
See this image and copyright information in PMC

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