Long COVID occurrence in COVID-19 survivors

Abstract

This cross-sectional study aimed to investigate the post-acute consequences of COVID-19. We conducted a self-administered questionnaire survey on sequelae, psychological distress (K6), impairments in work performance (WFun), and COVID-19-related experiences of stigma and discrimination in two designated COVID-19 hospitals in Hiroshima Prefecture, Japan, between August 2020 and March 2021. The prevalence of sequelae was calculated by age and COVID-19 severity. Factors independently associated with sequelae or psychological distress were identified using logistic regression analysis. Among 127 patients who had recovered from COVID-19, 52.0% had persistent symptoms at a median of 29 days [IQR 23-128] after COVID-19 onset. Among patients with mild COVID-19, 49.5% had sequelae. The most frequent symptoms were olfactory disorders (15.0%), taste disorders (14.2%), and cough (14.2%). Multivariate analysis showed that age was an independent risk factor for sequelae (adjusted odds ratios [AOR] for ≥ 60 years vs. < 40 years 3.63, p = 0.0165). Possible psychological distress was noted in 30.7% (17.9% of males and 45.0% of females). Female sex and the presence of sequelae were independent risk factors for psychological distress. Of all participants, 29.1% had possible impairments in work performance. Experiences of stigma and discrimination were reported by 43.3% of participants. This study revealed the significant impacts of Long COVID on health in local communities. A large-scale, long-term cohort study is desired.

Figure 1

Selection of the study population. The study was conducted among COVID-19 survivors in two designated COVID-19 hospitals in Hiroshima Prefecture, Japan. A total of 127 COVID-19 survivors were included.

Figure 2

Prevalence of Long COVID symptoms by age. Responses were collected at a median of 29 days [IQR 23–128] after COVID-19 onset. Asterisks (*) indicate statistically significant differences between age groups (p < 0.05, chi-square or Fisher’s exact test).

Figure 3

COVID-19–related experiences of stigma and discrimination. The pie chart on the left (a) shows the proportion of patients exposed to COVID-19–related stigma and discrimination (n = 127). The bar chart on the right (b) presents the typical forms of stigma and discrimination experienced by post–COVID-19 patients (n = 55).

Figure 4

Prevalence rates of deficits in work performance assessed using the WFun questionnaire. The Work Functioning Impairment Scale (WFun) was developed to evaluate deficits in work performance. Total scores of 7–13 were classified as normal, and scores ≥ 14 suggested possible impairments in work performance (14–20, mild; 21–27, moderate; and 28–35, severe). The gray, blue, and orange colors show the distribution of WFun scores for all subjects, males, and females, respectively. The intensity of the color relates to the severity of impairments in work performance. Chi-square test was applied to compare the distributions of WFun scores by sex and age group.

Figure 5

Prevalence of psychological distress assessed using the K6 questionnaire. The 6-item Kessler Psychological Distress Scale (K6) was developed to screen for mood and anxiety disorders. Total scores of 0–4 were classified as normal, and scores ≥ 5 suggested possible mood and anxiety disorders (5–9, mild; 10–14, moderate; and 15–24, severe). The gray, blue, and orange colors show the distribution of K6 scores for all subjects, males, and females, respectively. The intensity of the color relates to the severity of psychological distress. Chi-square test was applied to compare the distributions of K6 scores by sex and age group. Asterisk (*) indicates statistically significant difference (p < 0.05).