More than half of patients still experienced at least one post-Covid-19 symptom 2 years after acute infection, whether hospitalized or not, in a cross-sectional cohort study.
During the first wave of the epidemic, of the approximately 700 infected patients, 59.7% of those who were hospitalized and 67.5% of those who were not hospitalized developed at least one symptom.P=0.01), reported by Cesar Fernández-de-las-Penas, PT, PhD, King Juan Carlos University, Madrid, Spain, and colleagues. JAMA Network Open.
The most prevalent symptoms for the hospitalized and non-hospitalized groups at 2-year follow-up were:
- Fatigue: 44.7% vs 47.7%
- Pain (including headache): 35.8% vs 29.9%
- Memory Loss: 20% vs 15.9%
Our results showed a similar proportion of hospitalized and non-hospitalized patients with post-Covid-19 symptoms 2 years after the acute infection, suggesting that long-term COVID-19 symptoms are also present in the non-hospitalized group, even if they were not hospitalized at an acute stage. ,” the authors wrote. “This finding may be explained by the fact that the severity of Covid-19 is not a risk factor for the development of prolonged Covid symptoms.”
“Prolonged covid requires special management attention independent of whether the patient is hospitalized or not,” they concluded.
Note, uninfected controls were not included in this study. “The lack of inclusion of uninfected controls limits the ability to assess the direct association of SARS-CoV-2 infection with general and specific post-Covid-19 symptoms after 2 years,” they wrote. “Accordingly, future studies may include uninfected control populations.”
When patients first presented with Covid-19, the most frequent presenting symptoms were fever, dyspnea, myalgia, and cough, but dyspnea was more prevalent in hospitalized patients (31.1% vs 11.7% vs 11.7%). P<0.001) for anosmia in non-hospitalized patients (21.4% vs 10.0%; P=0.003).
Fernández-de-las-Penas et al., “These differences may be explained by the fact that individuals with less distressing and less painful symptoms (eg, anosmia, agosia, and sore throat) did not require hospitalization during the first wave of the epidemic.” The group wrote.
Among hospitalized patients, the number of pre-existing comorbidities was associated with post-Covid fatigue (OR 1.93, 95% CI 1.09–3.42, P=0.02) and dyspnea (OR 1.91, 95% CI 1.04–3.48, P=0.03), number of pre-existing comorbidities (OR 3.75, 95% CI 1.67-8.42, P=0.001) and number of symptoms at onset of illness (OR 3.84, 95% CI 1.33–11.05, P=0.01) were associated with post-Covid fatigue among non-hospitalized patients.
Most previous studies looking at post-Covid symptoms had shorter follow-up periods. one A meta-analysis The study, which included 40 studies and followed patients for up to 120 days, found a high prevalence of post-Covid symptoms between hospitalized patients and non-hospitalized patients. “The data on non-hospitalized patients are based on a follow-up period of no more than 6 months, so we cannot directly compare our results with previous data,” the authors said.
To assess symptoms of Covid-19 after 2 years, Fernández-de-las-Penas and his team included 360 hospitalized patients (mean age 60.7, 45% female) and 308 non-hospitalized patients (mean age 56.7, 59.4% female) from two urban hospitals. and several general medical centers infected with SARS-CoV-2 from March 20 to April 30, 2020. These patients did not experience reinfection during 2 years of follow-up.
Common comorbidities among hospitalized and nonhospitalized patients included hypertension (33.3% vs 24.7%), diabetes (13.6% vs 4.9%), heart disease (11.9% vs 11.0%), and obesity (7.8% vs 10.1%). .
Participants were scheduled for a telephone interview 2 years after acute infection. Hospitalization and clinical data were collected from medical records.
In addition to the inclusion of uninfected controls, other study limitations include that the researchers did not control for vaccination status. Furthermore, data were self-reported through telephone interviews, which may lead to recall bias.
This study was funded by the Community of Madrid and the European Union through the European Regional Development Fund REACT-UE resources from the Madrid Operational Program 2014-2020 as part of the Union’s response to the COVID-19 pandemic. 19.
Fernández-de-las-Penas reports no conflict of interest. A co-author reports receiving personal payments from the World Health Organization and financial support from the Gerencia Region de Salud Castilla y León during the conduct of this study.