Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug:133:67-74.
doi: 10.1016/j.ijid.2023.05.007. Epub 2023 May 12.

Trajectories of the evolution of post-COVID-19 condition, up to two years after symptoms onset

Clemence Servier  1 , Raphael Porcher  2 , Isabelle Pane  1 , Philippe Ravaud  3 , Viet-Thi Tran  4
Affiliations

Trajectories of the evolution of post-COVID-19 condition, up to two years after symptoms onset

Clemence Servier et al. Int J Infect Dis. 2023 Aug.

Abstract

Objectives: We aimed to identify trajectories of the evolution of post-COVID-19 condition, up to 2 years after symptom onset.

Methods: The ComPaRe long COVID e-cohort is a prospective cohort of patients with symptoms lasting at least 2 months after SARS-CoV2 infection. We used trajectory modeling to identify different trajectories in the evolution of post-COVID-19 condition, based on symptoms collected every 60 days using the long COVID Symptom Tool.

Results: A total of 2197 patients were enrolled in the cohort between December 2020 and July 2022 when the Omicron variant was not dominant. Three trajectories of the evolution of post-COVID-19 condition were identified: "high persistent symptoms" (4%), "rapidly decreasing symptoms" (5%), and "slowly decreasing symptoms" (91%). Participants with highly persistent symptoms were older and more likely to report a history of systemic diseases. They often reported tachycardia, bradycardia, palpitations, and arrhythmia. Participants with rapidly decreasing symptoms were younger and more likely to report a confirmed infection. They often reported diarrhea and back pain. Participants with slowly decreasing symptoms were more likely to have a history of functional diseases.

Conclusion: Most patients with post-COVID-19 condition improve slowly over time, while 5% have rapid improvement in the 2 years after symptom onset and 4% have a persistent condition.

Keywords: COVID-19; Endotypes; Long COVID; Natural history; Prospective cohort; Trajectory.

PubMed Disclaimer

Conflict of interest statement

Declarations of competing interest The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
The three trajectories of post-COVID-19 symptoms (n = 2197) The panels represent each of the three trajectories of post-COVID-19 condition identified using latent class mixed models. Trajectory 1 (panel A, blue line) represents participants with highly persistent symptoms. Trajectory 2 (panel B, red line) represents participants with rapidly decreasing symptoms. Trajectory 3 (panel C, green line) represents participants with slowly decreasing symptoms. Individual trajectories of symptoms for each participant can be visualized by thin gray lines. Participants were grouped according to the trajectory for which they had the highest probability of membership.
Figure 2
Figure 2
The three trajectories of post-COVID-19 symptoms among patients with laboratory-confirmed COVID-19 (n = 1526) The panels represent each of the three trajectories of post-COVID-19 condition identified using latent class mixed models among patients with laboratory-confirmed COVID-19. Trajectory 1 (panel A, blue line) represents participants with highly persistent symptoms. Trajectory 2 (panel B, red line) represents participants with rapidly decreasing symptoms. Trajectory 3 (panel C, green line) represents participants with slowly decreasing symptoms. Individual trajectories of symptoms for each participant can be visualized by thin gray lines. Participants were grouped according to the trajectory for which they had the highest probability of membership.
See this image and copyright information in PMC

References

    1. World Health Organization . 2023. WHO Coronavirus Disease (COVID-19) Dashboard. [accessed 19 April 2023] - PubMed

    2. https://covid19.who.int/

    1. Global Burden of Disease Long COVID Collaborators. Wulf Hanson S, Abbafati C, Aerts JG, Al-Aly Z, Ashbaugh C, et al. Estimated global proportions of individuals with persistent fatigue, cognitive, and respiratory symptom clusters following symptomatic COVID-19 in 2020 and 2021. JAMA. 2022;328:1604–1615. doi: 10.1001/jama.2022.18931. - DOI - PMC - PubMed
    1. Office for National Statistics . 2021. Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK. [accessed 2 September 2021]

    2. https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications.

    1. Fernández-de-Las-Peñas C, Rodríguez-Jiménez J, Cancela-Cilleruelo I, Guerrero-Peral A, Martín-Guerrero JD, García-Azorín D, et al. Post-COVID-19 symptoms 2 years after SARS-CoV-2 infection among hospitalized vs nonhospitalized patients. JAMA Netw Open. 2022;5 doi: 10.1001/jamanetworkopen.2022.42106. - DOI - PMC - PubMed
    1. Thompson EJ, Williams DM, Walker AJ, Mitchell RE, Niedzwiedz CL, Yang TC, et al. Long COVID burden and risk factors in 10 UK longitudinal studies and electronic health records. Nat Commun. 2022;13:3528. doi: 10.1038/s41467-022-30836-0. - DOI - PMC - PubMed