Long COVID reported in 15% of US adults with prior infection; vaccination lowers risk
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Approximately 15% of U.S. adults with a prior positive COVID-19 test report symptoms of long COVID, according to data published in JAMA Network Open.
The researchers further concluded that women and older patients demonstrated a greater risk for long COVID, while those who completed a primary vaccination series before they were infected were less likely to report long COVID symptoms.
“If high-risk individuals could be identified, it might be possible to develop strategies to mitigate or prevent symptom persistence, prompting calls for increased emphasis on investigation of post-acute sequelae of COVID-19,” Roy H. Perlis, MD, MSc, of Massachusetts General Hospital, and colleagues wrote. “A prior self-report study identified older age and female gender as correlates of greater risk for persistent COVID-19 symptoms; associations with gender were further supported in a U.K. survey.”
To examine the prevalence of long COVID, as well as the sociodemographic factors associated with it, Perlis and colleagues collected data from eight waves of the COVID-19 States Project, a large-scale internet survey that collected data every 6 weeks between Feb. 5, 2021, and July 6, 2022. Representative quotas were applied to balance gender, race, age and ethnicity. Respondents were asked about their COVID-19 test results and when they received the result. Those who reported any positive results were asked when their symptoms resolved, and those who had continued symptoms filled out a checklist of common symptoms.
In all, 16,091 participants were included in the study, among whom 10,075 were women. Of the included participants, 14.7% reported continued COVID-19 symptoms at least 2 months following their positive diagnosis. Among the 2,359 participants with these long COVID symptoms, 1,232 reported fatigue, 1,031 reported loss of smell, 1,079 reported poor memory, 952 reported “brain fog” and 937 reported shortness of breath.
According to the researchers, women were significantly more likely than men to report loss of smell — 46.4% vs. 35.3% (P < .001) — cognitive symptoms — 48.7% vs. 36.3% (P < .001) — anxiety — 30.8% vs. 22.3% (P < .001) — and sleep disruption — 32.4% vs. 22.5% (P < .001). In the exploratory analysis, symptom frequencies were similar by predominant variant at the time of initial infection, except for anosmia, which was less frequent when the omicron variant was predominant — 33.7% compared with 40.1% with the alpha variant and 50.5% for the delta variant (P < .001).
The researchers added that risk for long COVID was diminished with the completion of vaccination prior to infection (OR = 0.72; 95% CI, 0.06-0.86).
“In aggregate, the results of this cross-sectional study provide an estimate of the mean point prevalence of long COVID in a large, representative population sample of individuals in the United States, complementing studies using administrative claims, electronic health records, or COVID-19-focused self-report apps and surveys,” Perlis and colleagues wrote.
“They support the potential protective association of vaccination in reducing but not eliminating long COVID risk,” they added. “If confirmed in prospective studies, these results may facilitate risk stratification, with a goal of early intervention to minimize the effect of long COVID, and could contribute to efforts to prevent this syndrome altogether.”
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