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Multicenter Study
. 2025 Apr 15;25(1):1412.
doi: 10.1186/s12889-025-22671-x.

Follow-up of long COVID based on the definition of WHO: a multi-centre cross-sectional questionnaire-based study

Danying Yan #  1 , Ying Liu #  2 , Ran Chen  3 , Lei Zhou  4 , Chuwen Wang  1 , Ada Hoi Yan Ma  5 , Xueqin Chen  6 , Qifa Song  7 , Guoqing Qian  8   9
Affiliations
Multicenter Study

Follow-up of long COVID based on the definition of WHO: a multi-centre cross-sectional questionnaire-based study

Danying Yan et al. BMC Public Health. .

Abstract

Background: Since long COVID has hindered people from normal life, it is essential to understand its full spectrum of manifestation. However, it was heterogeneous in the existing studies and few large-scale studies have been conducted on Asian populations. Here, we conducted a multi-centre questionnaire-based study among Chinese people to explore the long COVID based on the definition of WHO.

Methods: During March 20, 2023 and June 18, 2023, individuals with a history of confirmed or self-reported SARS-CoV-2 infection were recruited from three hospitals to fill out the questionnaire for long COVID. Each symptom was assigned with 0 to 3 points based on their severity. And the long COVID score was a sum of these points of each symptom. The reporting rate, time trend and risk factors of long COVID stratified by different systems were explored.

Results: 3,693 individuals were recruited for the study. The reporting rate of at least one persistent long COVID symptoms and symptoms impacting daily life was 30.2% (1,117) and 10.7% (394). Systemic symptoms (20.7%, 765) were most easily reported. The most common symptoms were fatigue (16.3%, 602), cough (6.3%, 234) and expectoration (5.5%, 203). The reporting rate of long COVID and long COVID score decreased over time during a 180-day follow-up period (P < 0.05). For long COVID, older age (OR: 1.63, 1.38-1.93), female (OR: 1.19, 1.03-1.38) and SARS-CoV-2 reinfection (OR: 3.56, 2.63-4.80) were risk factors; while number of COVID-19 vaccine doses (OR: 0.87, 0.81-0.94) was a protective factor. The use of traditional Chinese medicine (OR: 0.51, 0.37-0.71) was a protective factor for symptoms impacting daily life.

Conclusions: Early interventions should be taken to minimize the impact of long COVID, especially for the elderly, females and those with SARS-CoV-2 reinfection. COVID-19 booster vaccination might play a potential role in minimizing the impact of long COVID.

Keywords: COVID-19; Long COVID; Post COVID-19 syndrome; Survey.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Ethical approval was granted by the First Affiliated Hospital of Ningbo University ethical committee (2023004A01). Informed consent was obtained from all subjects and/or their legal guardian(s). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of this study. Interval time, the interval between the initial SARS-CoV-2 infection time and the follow-up time
Fig. 2
Fig. 2
The reporting rate of long COVID stratified by different systems
Fig. 3
Fig. 3
Time trend of reporting rate and score of long COVID during a 180-day follow-up period. (A) Time trend of reporting rate of long COVID; (B) Time trend of reporting rate of symptoms impacting daily life; (C) Time trend of long COVID score among participants reporting at least one long COVID symptom; (D) Time trend of long COVID score among participants reporting symptoms impacting daily life
Fig. 4
Fig. 4
Time trend of reporting rate and score stratified by different systems during a 180-day follow-up period. A-E. Time trend of reporting rate of long COVID symptoms stratified by different systems; F-J. Time trend of score stratified by different systems
Fig. 5
Fig. 5
The multivariate logistic regression results of long COVID and symptoms impacting daily life. *, P < 0.05
See this image and copyright information in PMC

References

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