Prevalence and risk factors for long COVID after mild disease: A cohort study with a symptomatic control group

There is limited data on the prevalence and risk factors for long COVID and few prospective studies with appropriate control groups and adequate sample sizes. We performed a prospective study to determine the prevalence and risk factors for long COVID. We recruited individuals aged ≥15 years who wer...

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Bibliographic Details
Published in:	Journal of global health Vol. 13; p. 06015
Main Authors:	Cazé, Ana B, Cerqueira-Silva, Thiago, Bomfim, Adriele P, de Souza, Gisley L, Azevedo, Amanda Ca, Brasil, Michelle Qa, Santos, Nara R, Khouri, Ricardo, Dan, Jennifer, Bandeira, Antonio C, Cavalcanti, Luciano Pg, Barral-Netto, Manoel, Barral, Aldina, Barbosa, Cynara G, Boaventura, Viviane S
Format:	Journal Article
Language:	English
Published:	Scotland Edinburgh University Global Health Society 12-05-2023 International Society of Global Health
Subjects:	Body mass index Cohort analysis Cohort Studies Control Groups Coronaviruses COVID-19 COVID-19 - epidemiology Global health Hospitalization Humans Infections Olfaction disorders Pain Polymerase chain reaction Post-Acute COVID-19 Syndrome Prevalence Prospective Studies Quality of Life Questionnaires Risk Factors SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Sociodemographics Software Taste disorders Brazil
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Summary:	There is limited data on the prevalence and risk factors for long COVID and few prospective studies with appropriate control groups and adequate sample sizes. We performed a prospective study to determine the prevalence and risk factors for long COVID. We recruited individuals aged ≥15 years who were clinically suspected of having an acute SARS-CoV-2 infection from September 2020 to April 2021. We collected nasopharyngeal swabs three to five days following symptom onset for analysing using reverse transcriptase polymerase chain reaction (RT-PCR). We also collected clinical and sociodemographic characteristics from both SARS-CoV-2 positive and negative participants using structured questionnaires. We followed-up the participants via telephone interview to assess early outcomes and persistent symptoms. For COVID-19 cases, 5D-3L EuroQol questionnaire was used to assess the impact of symptoms on quality of life. We followed 814 participants (412 COVID-19 positive and 402 COVID-19 negative persons). Most (n = 741/814) had mild symptoms. Both groups had similar sociodemographic and clinical characteristics, except for the hospitalization rate (15.8% in the COVID-19 positive vs 1.5% in the COVID-19 negative group). One month after disease onset, 122/412 (29.6%) individuals in the COVID-19 positive (long COVID) and 24 (6%) in the COVID-19 negative group reported residual symptoms. In the long COVID group, fatigue, olfactory disorder, and myalgia were the most frequent symptoms in the acute phase. Compared to recovered individuals, older age and having more than five symptoms during the acute phase were risk factors for long COVID. Quality of life was evaluated in 102 out of 122 cases of long COVID, with 57 (55.9%) reporting an impact in at least one dimension of the European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L) questionnaire. In this prospective study consisting predominantly of individuals with mild disease, the persistence of symptoms after an acute respiratory illness was associated with a diagnosis of COVID-19. Polysymptomatic acute disease and older age were risk factors for long COVID.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Joint first authorship. Joint senior authorship.
ISSN:	2047-2978 2047-2986
DOI:	10.7189/JOGH.13.06015