The Greek Collaborative Long COVID Study: Non-Hospitalized and Hospitalized Patients Share Similar Symptom Patterns

Martha-Spyridoula Katsarou, Eleni Iasonidou, Alexander Osarogue, Efthymios Kalafatis, Maria Stefanatou, Sofia Pappa, Stylianos Gatzonis, Anastasia Verentzioti, Pantelis Gounopoulos, Christos Demponeras, Eleni Konstantinidou, Nikolaos Drakoulis, Andreas Asimakos, Archontoula Antonoglou, Aspasia Mavronasou, Stavroula Spetsioti, Anastasia Kotanidou, Paraskevi Katsaounou, Martha-Spyridoula Katsarou, Eleni Iasonidou, Alexander Osarogue, Efthymios Kalafatis, Maria Stefanatou, Sofia Pappa, Stylianos Gatzonis, Anastasia Verentzioti, Pantelis Gounopoulos, Christos Demponeras, Eleni Konstantinidou, Nikolaos Drakoulis, Andreas Asimakos, Archontoula Antonoglou, Aspasia Mavronasou, Stavroula Spetsioti, Anastasia Kotanidou, Paraskevi Katsaounou

Abstract

Long COVID-19 syndrome refers to persisting symptoms (>12 weeks) after the initial coronavirus infection and is estimated to affect 3% to 12% of people diagnosed with the disease globally. Aim: We conducted a collaborative study with the Long COVID patient organization in Greece, in order to estimate the characteristics, symptoms, and challenges these patients confront. Methods: Data were collected from 208 patients using unstructured qualitative free-text entries in an anonymized online questionnaire. Results: The majority of respondents (68.8%) were not hospitalized and reported lingering symptoms (66.8%) for more than six months. Eighteen different symptoms (fatigue, palpitations, shortness of breath, parosmia, etc.) were mentioned in both hospitalized and community patients. Awareness of Long COVID sequelae seems to be low even among medical doctors. Treatment options incorporating targeted rehabilitation programs are either not available or still not included inthe management plan of Long COVID patients. Conclusions: Patients infected with coronavirus with initial mild symptoms suffer from the same persistent symptoms as those who were hospitalized. Long COVID syndrome appears to be a multi-systemic entity and a multidisciplinary medical approach should be adopted in order to correctly diagnose and successfully manage these patients.

Keywords: Long COVID; post-COVID; post-acute COVID (PACS); post-acute sequelae of COVID-19 (PASC).

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Adjusted algorithm from Mount Sinai 2020 (Tabacof-Rehabilitation management of autonomic dysregulation in Post COVID-19 Condition (who.int)).
Figure 2
Figure 2
Long COVID Greek Supporting group response to questionnaire.
Figure 3
Figure 3
(a) Network Analysis graph of persistent symptoms. Larger nodes imply higher degree centrality. (b) Most frequently reported symptoms in Greek Long COVID society (LCGr).
Figure 4
Figure 4
Socioeconomic impact of Long COVID. ICU: Intensive care unit, N/A: Non available.
Figure 5
Figure 5
Decision tree reveals that fatigue appears to be muchhigher in patients with work problems.
Figure 6
Figure 6
Proposed holistic approach diagnostic algorithm. PE: pulmonary embolism; Chest X-ray; CT: Computer Tomography; PFTs: Pulmonary Function Tests, 6MWT: six minute walking test, CTPA: Computer Tomography pulmonary angiogram, lung U/S ultrasound, ECG electrocardiogram, MRI: Magnetic resonance imaging, EMG: electromyogram, Glu: Glucose, ANA: Antinuclear antibodies, CK: creatine kinase, TSH: Thyroid-stimulating hormone Test, freeT4: Free thyroxine test.

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