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. 2022 Mar 11;119(10):167-174.
doi: 10.3238/arztebl.m2022.0147.

Persisting Symptoms After COVID-19

Christian Förster  1 , Miriam Giovanna Colombo, Anna-Jasmin Wetzel, Peter Martus, Stefanie Joos
Affiliations

Persisting Symptoms After COVID-19

Christian Förster et al. Dtsch Arztebl Int. .

Abstract

Background: After recovering from coronavirus disease 2019 (COVID-19), a considerable number of patients report long-term sequelae. The epidemiologic data vary widely in the studies published to date, depending on the study design and the patient cohorts analyzed. Using a population-based approach, we report symptoms and clinical characteristics following COVID-19 (long COVID), focusing on symptoms ≥ 12 weeks (post-COVID-19).

Methods: In three German administrative districts, all adult patients with a diagnosis of COVID-19 confirmed by polymerase chain reaction (PCR) between March and September 2020 (n = 4632) were invited to complete a questionnaire. Predictors for post-COVID-19 were identified by multiple ordinal regression analysis. Study registration: DRKS00023069.

Results: A total of 1459 patients were included in the study, 175 (12%) of whom had been hospitalized for treatment of the acute phase of COVID-19. The prevalence of post-COVID-19 was 72.6% (n = 127) and 46.2% (n = 588) for hospitalized and non-hospitalized patients, respectively. The most frequently occurring long-term symptoms were fatigue (41.5% of all symptoms ≥ 12 weeks, n = 297), physical exhaustion (40.8%, n = 292), difficulty in concentrating (30.6%, n = 219), and loss of the senses of taste (25.9%, n = 185) and smell (25.5%, n = 182). Quality of life was significantly impaired in patients with post-COVID-19. The strongest risk factors for post-COVID-19 were female sex, overall severity of comorbidities, and severity of acute COVID-19.

Conclusion: Patients who are not hospitalized also frequently experience continued symptoms following COVID-19. The heterogeneity of symptoms calls for a multi - disciplinary stepped-care approach, for which identification of patients at risk is crucial. A limitation of the study is the lack of a control group.

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Figures

Figure
Figure
Prevalence of symptoms following COVID-19 in a population-based cohort. Proportions of participants who had the respective symptom for less than 12 weeks (acute and ongoing COVID-19) or for at least 12 weeks (post-COVID-19) after the infection. a) symptoms of non-hospitalized patients (n = 1273); b) symptoms of hospitalized patients (n = 175)
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