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. 2022 Jul 6;20(1):244.
doi: 10.1186/s12916-022-02448-4.

Prevalence and risk factors of post-COVID-19 condition in adults and children at 6 and 12 months after hospital discharge: a prospective, cohort study in Moscow (StopCOVID)

Ekaterina Pazukhina #  1   2 , Margarita Andreeva #  3 , Ekaterina Spiridonova #  3 , Polina Bobkova #  3 , Anastasia Shikhaleva #  3 , Yasmin El-Taravi #  3 , Mikhail Rumyantsev #  3 , Aysylu Gamirova #  3 , Anastasiia Bairashevskaia  3 , Polina Petrova  3 , Dina Baimukhambetova  3 , Maria Pikuza  3 , Elina Abdeeva  3 , Yulia Filippova  3 , Salima Deunezhewa  3 , Nikita Nekliudov  3 , Polina Bugaeva  3 , Nikolay Bulanov  4 , Sergey Avdeev  5 , Valentina Kapustina  6 , Alla Guekht  7   8 , Audrey DunnGalvin  3   9 , Pasquale Comberiati  10 , Diego G Peroni  10 , Christian Apfelbacher  11 , Jon Genuneit  12 , Luis Felipe Reyes  13   14 , Caroline L H Brackel  15   16 , Victor Fomin  17 , Andrey A Svistunov  17 , Peter Timashev  18 , Lyudmila Mazankova  19 , Alexandra Miroshina  20 , Elmira Samitova  19   20 , Svetlana Borzakova  8   21 , Elena Bondarenko  3 , Anatoliy A Korsunskiy  3 , Gail Carson  22 , Louise Sigfrid  22 , Janet T Scott  23 , Matthew Greenhawt  24 , Danilo Buonsenso  25   26   27 , Malcolm G Semple  28   29 , John O Warner  30 , Piero Olliaro  22 , Dale M Needham  31   32   33 , Petr Glybochko  17 , Denis Butnaru  17 , Ismail M Osmanov #  8   20 , Daniel Munblit #  34   35   36 ; Sechenov StopCOVID Research Team
Collaborators, Affiliations

Prevalence and risk factors of post-COVID-19 condition in adults and children at 6 and 12 months after hospital discharge: a prospective, cohort study in Moscow (StopCOVID)

Ekaterina Pazukhina et al. BMC Med. .

Abstract

Background: Previous studies assessing the prevalence of COVID-19 sequelae in adults and children were performed in the absence of an agreed definition. We investigated prevalence of post-COVID-19 condition (PCC) (WHO definition), at 6- and 12-months follow-up, amongst previously hospitalised adults and children and assessed risk factors.

Methods: Prospective cohort study of children and adults with confirmed COVID-19 in Moscow, hospitalised between April and August, 2020. Two follow-up telephone interviews, using the International Severe Acute Respiratory and Emerging Infection Consortium survey, were performed at 6 and 12 months after discharge.

Results: One thousand thirteen of 2509 (40%) of adults and 360 of 849 (42%) of children discharged participated in both the 6- and 12-month follow-ups. PCC prevalence was 50% (95% CI 47-53) in adults and 20% (95% CI 16-24) in children at 6 months, with decline to 34% (95% CI 31-37) and 11% (95% CI 8-14), respectively, at 12 months. In adults, female sex was associated with PCC at 6- and 12-month follow-up (OR 2.04, 95% CI 1.57 to 2.65) and (OR 2.04, 1.54 to 2.69), respectively. Pre-existing hypertension (OR 1.42, 1.04 to 1.94) was associated with post-COVID-19 condition at 12 months. In children, neurological comorbidities were associated with PCC both at 6 months (OR 4.38, 1.36 to 15.67) and 12 months (OR 8.96, 2.55 to 34.82) while allergic respiratory diseases were associated at 12 months (OR 2.66, 1.04 to 6.47).

Conclusions: Although prevalence of PCC declined one year after discharge, one in three adults and one in ten children experienced ongoing sequelae. In adults, females and persons with pre-existing hypertension, and in children, persons with neurological comorbidities or allergic respiratory diseases are at higher risk of PCC.

Keywords: Adults; COVID-19; COVID-19 sequelae; Children; Long COVID; PASC; Post-COVID-19 condition; Post-acute sequelae of SARS-CoV-2 infection; Prevalence; Risk factor.

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Conflict of interest statement

JTS is supported by Welcome. CLHB declares a grant from The Netherlands Organisation for Health Research and Development. CA declares grant by Federal Ministry of Education and Research (BMBF) for EgePan Unimed project involving research activities on post-COVID-19 condition received by his institution. JG declares grants from the German Federal Ministry of Education and Research, German Federal Ministry of Health, and Danone Nutricia Research reception by his institution. He also reports Danone Nutricia Research patents in the area of breast milk composition pending. He acknowledges receiving an honorarium for serving as an Associate Editor for the Journal Pediatric Allergy and Immunology. MGS reports grants from the National Institute of Health Research UK, Medical Research Council UK, and Health Protection Research Unit in Emerging & Zoonotic Infections, University of Liverpool. He is also an independent external and non-remunerated member of Pfizer’s External Data Monitoring Committee for their mRNA vaccine program(s), a Chair of Infectious Disease Scientific Advisory Board of Integrum Scientific LLC, Greensboro, NC, USA, director of MedEx Solutions Ltd. He also declares being a minority owner at Integrum Scientific LLC, Greensboro, NC, USA, and majority owner at MedEx Solutions Ltd. He reports that a gift from Chiesi Farmaceutici S.p.A. was received by his Institution of Clinical Trial Investigational Medicinal Product without encumbrance and distribution of same to trial sites. He also serves as a non-remunerated independent member of HMG UK Scientific Advisory Group for Emergencies (SAGE), COVID-19 Response, and HMG UK New Emerging Respiratory Virus Threats Advisory Group (NERVTAG). LS declares project funding from the Welcome Trust. DB has participated to a peer-to-peer (PAACE) educational program on long COVID, sponsored by Pfizer. JOW reports funding from Danone/Nutricia, Friesland-Campina, and Airsonett. He also serves an Anaphylaxis Campaign clinical and scientific panel chairman and acknowledges travel expenses as a speaker covered by the World Allergy Organisation. DM reports receipt of grants from the British Embassy in Moscow, UK National Institute for Health Research (NIHR) and Russian Foundation for Basic Research. He also Co-Chair of International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) Global Paediatric Long COVID Working Group, member of ISARIC working group on long-term follow-up in adults, and co-lead of the PC-COS project. Other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of patients admitted with PCR-confirmed COVID-19 to Sechenov University Hospital Network (adults) and Z.A. Bashlyaeva Children’s Municipal Clinical Hospital (children)
Fig. 2
Fig. 2
Forest plots demonstrating the prevalence of post-COVID-19 condition manifestations in adults and children 6 and 12 months after hospital discharge. Sixth-month prevalence is coloured in red, and 12-month prevalence is coloured in blue. Estimates of the prevalence 95% confidence intervals were calculated using the bootstrapping method
Fig. 3
Fig. 3
Interrelations between the post-COVID-19 condition manifestations in adults and children 6 and 12 months since hospital discharge. Bubble diameter is proportional to the proportion of individuals with the symptom category reported. Line thickness is proportional to the number of individuals with the coexisting manifestations. Cardiovascular, CRD; dermatological, DRM; fatigue, FTG; gastrointestinal, GST; musculoskeletal, MSC; neurocognitive, NRL; respiratory, RSP; sensory, SNS; sleep, SLP
Fig. 4
Fig. 4
A Radial plots representing post-COVID-19 condition phenotypes in adults at 6 months after discharge and 12 months after discharge. Manifestations are shown for each patient; each segment represents a single patient. Thick black lines are used to distinct phenotypes. Cardiovascular, CRD; dermatological, DRM; fatigue, FTG; gastrointestinal, GST; musculoskeletal, MSC; neurocognitive, NRL; respiratory, RSP; sensory, SNS; sleep, SLP. B Radial plots representing post-COVID-19 condition phenotypes in children at 6 months after discharge and 12 months after discharge. Manifestations are shown for each patient; each segment represents a single patient. Thick black lines are used to distinct phenotypes. Cardiovascular, CRD; dermatological, DRM; fatigue, FTG; gastrointestinal, GST; musculoskeletal, MSC; neurocognitive, NRL; respiratory, RSP; sensory, SNS; sleep, SLP
Fig. 5
Fig. 5
A Multivariable logistic regression model demonstrating risk factors associated with post-COVID-19 condition in adults at 6-month follow-up. Odds ratios and 95% CIs are presented. B Multivariable logistic regression model demonstrating risk factors associated with post-COVID-19 condition in adults at 12-month follow-up. Odds ratios and 95% CIs are presented. C Multivariable logistic regression model demonstrating risk factors associated with post-COVID-19 condition in children at 6-month follow-up. Odds ratios and 95% CIs are presented. D Multivariable logistic regression model demonstrating risk factors associated with post-COVID-19 condition in children at 12-month follow-up. Odds ratios and 95% CIs are presented
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