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Multicenter Study
. 2025 Mar 12;48(1):e1101.
doi: 10.23938/ASSN.1101.

[Long-term persistence of post-COVID-19 symptoms: A two-year follow-up of a Primary Care cohort]

[Article in Spanish]
Yolanda Barrera Martínez  1 , Gerardo Andrés Boillat Oriani  2 , Pedro Vega Montes  3 , Elena Martínez Moreno  4 , Alejandro Pérez Pérez  5 , Ricardo José Casajuana Pérez  6 , Francisca Muñoz Cobos  7
Affiliations
Multicenter Study

[Long-term persistence of post-COVID-19 symptoms: A two-year follow-up of a Primary Care cohort]

[Article in Spanish]
Yolanda Barrera Martínez et al. An Sist Sanit Navar. .

Abstract
in English, Spanish

Background: This study aims to determine the prevalence of long COVID two years after initial infection, identify prognostic factors, and assess its impact on quality of life.

Methodology: An ambispective cohort study was conducted with patients aged = 18 years from two health centers in Málaga, Spain, who tested positive for SARS-CoV-2 between October 2020 and May 2021. Systematic random sampling was performed in October 2022, with 5% precision, 5% alpha error, and 25% expected losses. The cohort was followed until May 2023. Dependent variables included long COVID (= 1 symptom lasting =8 weeks), symptom count, quality of life (EuroQol 5-D), and global health perception (EQ-EVA). Independent variables included age, sex, severity of initial infection severity, vaccination status, comorbidities, and reinfection.

Results: Of 914 eligible individuals, 173 patients were sampled (mean age 47 years, 58.4% female). Long COVID was observed in 32.36% of participants, with 23% affected two years after infection. Fatigue and anosmia/dysgeusia were the most frequent symptoms. Prognostic factors for long COVID included higher initial infection severity, younger age, and reinfection. For symptom count, factors were depression, initial infection severity, and reinfection. Health perception was eight points lower in long COVID patients (77.72: SD=17.10 vs 86.15; SD=16.25; p<0.001). Female sex, older age, fewer comorbidities, and more vaccine doses were associated with better quality of life.

Conclusions: Thirty-two percent of patients experienced long COVID, mainly fatigue and anosmia/dysgeusia. It associates with higher initial severity, younger age, and reinfection, negatively impacting quality of life.

Fundamento:: Determinar la prevalencia de COVID persistente en los dos años tras la primo-infección, identificar sus factores pronóstico y evaluar su impacto en la calidad de vida.

Metodología:: Estudio ambispectivo de cohortes realizado en pacientes ≥18 años adscritos a dos centros de salud (Málaga, España), con PCR/test de antígeno positivo para SARS-CoV-2 entre octubre/2020 y mayo/2021. Se realizó un muestreo aleatorio sistemático en octubre de 2022, asumiendo precisión=5%, confianza=95% y pérdidas=25%. El seguimiento finalizó en mayo/2023. Variables dependientes: COVID persistente (≥1 síntoma durante ≥8 semanas), número de síntomas, calidad de vida (EuroQol 5-D) y percepción global de salud (EQ-EVA). Variables independientes: edad, sexo, gravedad de la infección inicial, vacunación, comorbilidades, reinfección.

Resultados:: Se muestrearon 173 pacientes de 914 elegibles, con edad media 47 años y 58,4% mujeres. El 32,36% presentaron COVID persistente en algún momento y un 23% a los dos años de la primoinfección, siendo los síntomas más frecuentes astenia y anosmia/disgeusia. Los factores pronóstico de COVID persistente fueron primoinfección más grave, menor edad y reinfección, mientras depresión, primoinfección más grave y reinfección lo fueron para mayor número de síntomas. La percepción global de salud fue ocho puntos menor en pacientes con COVID persistente (77,72; DE=17,10 vs 86,15; DE=16,25; p <0,001). Sexo femenino, mayor edad, menos comorbilidades y más dosis vacunales predijeron mayor calidad de vida.

Conclusiones:: El 32% de pacientes presentó COVID persistente, principalmente astenia y anosmia/disgeusia. La persistencia se asoció con mayor gravedad inicial, menor edad y reinfección, afectando negativamente la calidad de vida.

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Conflict of interest statement

Conflictos de intereses: Los autores declaran no tener conflictos de intereses.

Figures

Figura 1. Proceso
Figura 1. Proceso. de selección de la muestra.
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