Course of post COVID-19 disease symptoms over time in the ComPaRe long COVID prospective e-cohort

Abstract

About 10% of people infected by severe acute respiratory syndrome coronavirus 2 experience post COVID-19 disease. We analysed data from 968 adult patients (5350 person-months) with a confirmed infection enroled in the ComPaRe long COVID cohort, a disease prevalent prospective e-cohort of such patients in France. Day-by-day prevalence of post COVID-19 symptoms was determined from patients' responses to the Long COVID Symptom Tool, a validated self-reported questionnaire assessing 53 symptoms. Among patients symptomatic after 2 months, 85% still reported symptoms one year after their symptom onset. Evolution of symptoms showed a decreasing prevalence over time for 27/53 symptoms (e.g., loss of taste/smell); a stable prevalence over time for 18/53 symptoms (e.g., dyspnoea), and an increasing prevalence over time for 8/53 symptoms (e.g., paraesthesia). The disease impact on patients' lives began increasing 6 months after onset. Our results are of importance to understand the natural history of post COVID-19 disease.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1. Study flow chart.

*The high number of patients without a confirmed infection is due to the limited availability of testing during the first wave of COVID-19 in March 2020, in France.

Fig. 2. Cumulative event curve for remission of post COVID-19 symptoms.

Time of remission was defined as the first time that patients reported no longer experiencing any symptoms of post COVID-19 disease. The time at risk started at entry in the cohort and ended on October 10, 2021. Follow-up data were censored at the participants’ latest observation point. Error bands represent 95% confidence intervals. Source data are provided as a Source Data file.

Fig. 3. Day-by-day trends in the prevalence of post COVID-19 disease symptoms (A) and of their impact on patients’ lives (B).

A The figure presents the day-by-day prevalence of each of the 53 symptoms assessed by the Long COVID ST (grey lines). Examples of specific symptoms have been highlighted (coloured lines). For each symptom and at each observation point, we assumed that patients could either be “experiencing” or “not experiencing” the symptom. We assumed that their state at an arbitrary time was the same as the state at their previous observation point and that their states before their first observation and after their last observation are unknown. B The figure presents the day-by-day evolution of the six domains of patients’ lives that can be affected by post COVID-19 disease and are assessed by the Long COVID IT. For each item and at each observation point, we modelled patients answers as either “reporting” a significant impact of the disease on this domain” (i.e., item score >7) or “not reporting” this impact (i.e., item score <8). We assumed that their state at an arbitrary time was the same as the state at their previous observation point and that their states before their first observation and after their last observation are unknown. The red lines represent a similar model for the Patient Acceptable Symptomatic State (PASS) of the long COVID IT, which is the long COVID IT score below which 75% of patients find that their disease state is acceptable. Source data are provided as a Source Data file.