Long COVID Symptomatology After 12 Months and Its Impact on Quality of Life According to Initial Coronavirus Disease 2019 Disease Severity

Aurélie Fischer, Lu Zhang, Abir Elbéji, Paul Wilmes, Pauline Oustric, Therese Staub, Petr V Nazarov, Markus Ollert, Guy Fagherazzi, Aurélie Fischer, Lu Zhang, Abir Elbéji, Paul Wilmes, Pauline Oustric, Therese Staub, Petr V Nazarov, Markus Ollert, Guy Fagherazzi

Abstract

Background: "Long COVID" is characterized by a variety of symptoms and an important burden for affected people. Our objective was to describe long COVID symptomatology according to initial coronavirus disease 2019 (COVID-19) severity.

Methods: Predi-COVID cohort study participants, recruited at the time of acute COVID-19 infection, completed a detailed 12-month symptom and quality of life questionnaire. Frequencies and co-occurrences of symptoms were assessed.

Results: Among the 289 participants who fully completed the 12-month questionnaire, 59.5% reported at least 1 symptom, with a median of 6 symptoms. Participants with an initial moderate or severe acute illness declared more frequently 1 or more symptoms (82.6% vs 38.6%, P < .001) and had on average 6.8 more symptoms (95% confidence interval, 4.18-9.38) than initially asymptomatic participants who developed symptoms after the acute infection. Overall, 12.5% of the participants could not envisage coping with their symptoms in the long term. Frequently reported symptoms, such as neurological and cardiovascular symptoms, but also less frequent ones such as gastrointestinal symptoms, tended to cluster.

Conclusions: Frequencies and burden of symptoms present 12 months after acute COVID-19 infection increased with the severity of the acute illness. Long COVID likely consists of multiple subcategories rather than a single entity. This work will contribute to the better understanding of long COVID and to the definition of precision health strategies.

Clinical trials registration: NCT04380987.

Keywords: COVID-19; SARS-CoV-2; cluster; long COVID; severity; symptoms.

© The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

Figures

Figure 1.
Figure 1.
Description of 60 persisting symptoms, 12 months after the acute infection. Symptoms are grouped by symptom category according to disease severity during acute infection. Four symptoms are not presented as no participants reported them: infarction, stroke, hallucinations, and necessity of dialysis.
Figure 2.
Figure 2.
Co-occurrence heatmap of the 60 most frequent symptoms present 12 months after acute infection. A, Co-occurrences are presented as percentage per line (eg, line “Depression,” we show the percentage of participants reporting depression and having the second symptom). B, Dendrogram indicates the order in which the symptoms were clustered. The smaller height reflects the earlier joining and the higher similarity between the clusters/symptoms.

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