Prevalence of Long COVID Symptoms Related to SARS-CoV-2 Strains

Abstract

Background: Few studies have assessed the differences of patterns of Long COVID (L-COVID) with regards to the pathogenetic SARS-CoV-2 strains.

Objectives: To investigate the relationship between demographic and clinical characteristics of acute phase of infection and the persistence of L-COVID symptoms and clinical presentation across different SARS-CoV-2 strains.

Methods: In this observational-multicenter study we recorded all demographic and clinical characteristics, severity of infection, presence/persistence of symptoms of fatigue, dyspnoea and altered quality of life (QoL) at baseline and after 6 months, in a sample of Italian patients from Liguria between March 2020 and March 2022.

Results: 308 patients (mean age 63.2 years; 55.5% men) with previous COVID were enrolled. Obese patients were 21.2% with a significant difference in obesity prevalence across the second and third wave (p = 0.012). Treatment strategies differed between waves (p < 0.001): more patients required invasive mechanical ventilation in the first wave, more patients were treated with high-flow nasal cannula/non-invasive ventilation in the in the second and more patients were treated with oxygen-therapy in the fourth wave. At baseline, a high proportion of patients were symptomatic (dyspnoea and fatigue), with impairment in some QoL indicators. A higher prevalence of patients with pain, were seen in the first wave compared to later infections (p = 0.01). At follow-up, we observed improvement of dyspnoea, fatigue and some dimensions of QoL scale evaluation such as mobility, usual activities, pain evaluations; instead there was no improvement in remaining QoL scale indicators (usual care and anxiety-depression).

Conclusions: There were no significant differences in the prevalence of the most frequent L-COVID symptoms, except for QoL pain domain that was especially associated with classical variant. Our results show substantial impact on social and professional life and usual care activities. These findings highlight the importance of multidisciplinary post COVID follow-up care including mental health support and rehabilitation program.

Keywords: Long COVID; SARS-CoV-2; post COVID; stains; variants.

Figure 1

COVID-19 cases in Liguria from March 2020 and March 2022 (data from Department of Protezione Civile). Data from: https://mappe.protezionecivile.gov.it/it/mappe-e-dashboards-emergenze/dashboards-coronavirus/situazione-desktop/ accessed on 9 July 2023.

Figure 2

Differences in prevalence of dyspnea, fatigue and problems in quality of life at baseline and follow-up visit. The degree of dyspnoea (4 point scale), the degree of fatigue (3 point scale) and the degree of problems on 5 domains of quality of life (3 point scale) were compared at baseline and follow-up visit in the same subjects. The McNemar Bowker test was used for comparisons. * p < 0.05.

Figure 3

Differences in prevalence of dyspnoea, fatigue ed problems in quality of life at baseline and follow-up visit in the COVID-19 waves. Dyspnoea (Yes vs. No), fatigue (Yes vs. No) and the 5 domains of quality of life (Problems vs. no problems) were compared at baseline and follow-up visit in the same subjects. The McNemar test was used for comparisons. * p < 0.05.