Nearly half of patients with symptomatic COVID-19 fail to recover after 6 to 18 months
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Approximately 48% patients who develop symptomatic COVID-19 either fail to recover or achieve only partial recovery within 6 to 18 months after infection, according to data published in Nature Communications.
“With increasing numbers of people having been infected since the start of the pandemic, attention is shifting from managing the acute infection to understanding long COVID in order to inform the health and social care response,” Claire E. Hastie, PhD, of the Institute of Health and Wellbeing, at the University of Glasgow, in the United Kingdom, and colleagues wrote. “The WHO defined long COVID as ‘a history of probable or confirmed SARS-CoV-2 infection with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis.’
“The imprecision of this, and other, definitions reflects our poor understanding of the nature of long COVID and its underlying mechanisms,” they added.
To investigate the frequency and impact of long COVID in a generalized population, Hastie and colleagues conducted the Long-COVID in Scotland Study, an ambidirectional, general population cohort. The researchers invited every adult in Scotland, defined as individuals aged 16 years and older, who has demonstrated a positive PCR test since April 2020 to participate in the study. A comparator group consisting of patients who had tested negative, but never positive, on a PCR test was also included. The groups were matched 3:1 based on age, sex and their area-based socioeconomic deprivation quantile, the researchers wrote. The study included retrospective and prospective samples.
Participants were asked to complete an online survey detailing preexisting conditions present at the time of the positive COVID-19 test, current symptoms, lifestyle limitations and quality of life. Patients who tested positive also were additionally asked about symptoms during acute illness and their current recovery status. The surveys were completed at 6, 12 and 18 months following the index test.
The study outcomes included evaluations of 26 symptoms, limitations across seven daily activities, quality of life related to health, hospitalization, ICU admission and all-cause mortality. Patients with symptomatic infection were evaluated based on recovery status as well, the researchers wrote.
The analysis included a total of 31,486 patients who had symptomatic COVID-19 infections, and 62,957 individuals in the comparator group. Among of the patients with symptomatic infections, 6% reported that they had not recovered, while 42% reported that they had only recovered partially, according to the researchers.
In addition, previous symptomatic infection was associated with poorer quality of life, impairment across all daily activities and 24 persistent symptoms. These symptoms included shortness of breath (OR = 3.43; 95% CI, 3.29-3.58), palpitations (OR = 2.51; 95% CI, 2.36-2.66), chest pain (OR = 2.09; 95% CI, 1.96-2.23) and confusion (OR = 2.92; 95% CI, 2.78-3.07). Asymptomatic infections did not appear to correlate with adverse outcomes, the researchers added.
“In conclusion, 6 to 18 months following symptomatic SARS-CoV-2 infection, adults were at greater risk of a diverse group of symptoms, poorer quality of life and wide-ranging impairment of their daily activities, which could not be explained by confounding,” Hastie and colleagues wrote. “Sequelae were more likely following severe infection and were not observed following asymptomatic infection and pre-infection vaccination may be protective.”
References:
A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1. Oct. 6, 2021. Accessed October 13, 2022.
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