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. 2025 Mar 12:13:1513664.
doi: 10.3389/fpubh.2025.1513664. eCollection 2025.

Post-infection symptoms up to 24 months after COVID-19: a matched cohort study in Berlin, Germany

Anne Meierkord  1   2 , Daniel Schulze  3 , Maximilian Gertler  1 , Joachim Seybold  4 , Marcus A Mall  5   6   7 , Tobias Kurth  8 , Frank P Mockenhaupt #  1 , Stefanie Theuring #  1
Affiliations

Post-infection symptoms up to 24 months after COVID-19: a matched cohort study in Berlin, Germany

Anne Meierkord et al. Front Public Health. .

Abstract

Introduction: Long-term health consequences after mild COVID-19 are not well described. Our aim was to estimate their prevalence and describe the time course of signs and symptoms for a period of up to 24 months after SARS-CoV-2 infection.

Methods: We conducted a cohort study matched for age, sex, and test week among individuals who had attended the public COVID-19 test center at Charité-Universitätsmedizin Berlin, Germany. In early 2022, 576 former COVID-19 patients (>95% non-hospitalized) and 302 uninfected individuals responded to a questionnaire on retrospective monthly symptoms since the test date up to 24 months ago.

Results: Symptoms compatible with long COVID were present in 42.9% (247/576) of former COVID-19 patients, compared with 21.2% (64/302) in the uninfected group. In former patients, unadjusted odds ratios (OR) were highest for disturbed taste/smell (OR 9.1 [95% CI: 4.0-21.1]), memory difficulties (OR 5.1 [95% CI: 2.9-8.9]), and shortness of breath at rest (OR 4.5 [95% CI: 1.9-10.6]). In most former COVID-19 patients, symptoms occurred in one coherent period and resolved after a median of 6.5 months, while taste/smell disturbance and neurological/cognitive symptoms showed longer times until recovery. Factors associated with long COVID-compatible symptoms included hospitalization, symptomatic COVID-19 infection, low household income and female sex.

Conclusion: Post-infection symptoms in mild COVID-19 patients mostly persist for about half a year, but sometimes longer. Among uninfected individuals who never experienced COVID-19, 21.2% also reported long COVID-compatible symptoms. The current long COVID definition might require revision to prevent misclassification and over-reporting, and to improve diagnosis and prevalence estimates.

Keywords: COVID-19; SARS-CoV-2; long COVID; post COVID-19 condition; post-acute sequel of COVID-19.

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Conflict of interest statement

Outside of this work, TK reported receiving research grants from the German Federal Joint Committee (G-BA) and the Federal Ministry of Health (BMG). He reported receiving personal compensation from Eli Lilly & Company, the BMJ, and Frontiers. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of people invited to participate in the study.
Figure 2
Figure 2
Percentage of participants who experienced any symptom compatible with long COVID following their SARS-CoV-2 test at month 3–24.
See this image and copyright information in PMC

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