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. 2025 Jul 22.
doi: 10.1007/s11739-025-04051-w. Online ahead of print.

Persistence of symptoms in long-COVID: follow-up trajectories of 30 symptoms in 755 patients from a national multicenter study from Italy

Marco Floridia  1 , Liliana Elena Weimer  2 , Patrizia Rovere Querini  3 , Paolo Bonfanti  4   5 , Donato Lacedonia  6 , Stefano Figliozzi  7   8 , Silvia Zucco  9 , Paola Andreozzi  10 , Emanuela Barisione  11 , Aldo Lo Forte  12 , Paola Gnerre  13 , Kwelusukila Loso  14 , Graziano Onder  15   16 ; ISS Long-COVID Study Group
Collaborators, Affiliations

Persistence of symptoms in long-COVID: follow-up trajectories of 30 symptoms in 755 patients from a national multicenter study from Italy

Marco Floridia et al. Intern Emerg Med. .

Abstract

Aim of the study was to define the patterns and determinants of symptom persistence in Long-COVID. The study population was represented by a multicenter cohort of patients with persisting symptoms after SARS-CoV-2 infection. Data collection included demographics, comorbidities, characteristics of acute infection, vaccination, reinfection, plus 30 different symptoms. The associations between covariates and persistence were assessed in multivariable logistic regression models. The study evaluated, at a mean interval of 453 days from acute SARS-CoV-2 infection, symptom persistence in 755 patients who had Long-COVID symptoms at a mean interval of 223 days from COVID-19. At second evaluation, 423 (56.0%) patients still presented one or more symptoms and 332 (44.0%) were symptom free. In those who remained symptomatic, the mean number of symptoms significantly reduced between the two evaluations. Compared to the first evaluation, the overall mean symptom regression rate was 72%, with lower regression rates observed for dyspnea (53%), anxiety (54%) and sleep disturbances (55%). The risk of persistence was increased for female sex, higher BMI, hospitalization and stronger ventilatory support during acute disease, higher number of initial symptoms and particular comorbidities (anxiety, chronic pulmonary disease, asthma), and decreased with the increase of age and time from acute SARS-CoV-2 infection. Neither SARS-CoV-2 vaccination nor reinfection showed significant associations with persistence. In this case series, roughly half of the patients that were symptomatic 7 months after acute SARS-CoV-2 infection remained symptomatic after an additional 7 months. The pattern and predictors of persistence draw attention to certain particular risk factors and manifestations that tend to persist longer than others.

Keywords: COVID-19; Dyspnea; Fatigue; Long-COVID; Symptoms.

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Conflict of interest statement

Declarations. Conflict of interest: None. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be considered as a potential conflict of interest. Ethical approval: The Italian National Ethics Committee approved the project (AOO-ISS—19/04/2022-0015066 Class: PRE BIO CE 01.00). Consent to participate: Patient participation was on a voluntary basis and written informed consent was required for inclusion, using a patient information and consent form also approved by the Italian National Ethics Committee.

References

    1. World Health Organization (WHO) Post COVID-19 condition (Long COVID). 7 December 2022. Available at: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-cond... . Accessed March 3rd, 2025
    1. National Institute for Health and Care Excellence (NICE) NICE Guideline, No. 188, 2020 Dec 18: COVID-19 rapid guideline: managing the long-term effects of COVID-19
    1. Centers for Diseases Control and Prevention (CDC) Long COVID basics. Available at: https://www.cdc.gov/covid/long-term-effects/index.html#:~:text=Long%20CO... . Accessed March 3rd, 2025
    1. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Global Health; Board on Health Sciences Policy; Committee on Examining the Working Definition for Long COVID; Goldowitz I, Worku T, Brown L, Fineberg HV, editors. A long COVID definition: a chronic, systemic disease state with profound consequences. Washington (DC): National Academies Press (US); 2024 Jul 9.
    1. World Health Organization (WHO) COVID-19 epidemiological update. Edition 167, 17 May 2024. Available at: https://www.who.int/publications/m/item/covid-19-epidemiological-update-... . Accessed March 3rd, 2025.

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