For adults infected with COVID-19 during the pre-Delta variant period, female sex, acute disease severity, and higher number of preexisting conditions were found to be associated with increased risk of developing long COVID. Monitoring long COVID and the effects that vaccination and COVID-19-specific treatments have on its occurrence may help reduce disease prevalence in the United States. These study results were published in Clinical Infectious Disease.
Researchers analyzed data from 4 state-level COVID-19 case reporting systems and patient-reported surveys to evaluate the prevalence of long COVID and associated risk factors among adults with laboratory-confirmed SARS-CoV-2 infection. The analysis included adults from Maine, New Jersey, New York, and Wisconsin who tested positive for infection during the pre-Delta era (March-December 2020). Weighted regression models were used to estimate disease prevalence, identify risk factors, and examine associations between symptom clusters and time to return to usual state of health following initial infection.
A total of 4172 survey responses were evaluated, of which 52% were among women, 66% were among non-Hispanic White individuals, and 47% were among those who resided in large fringe metros. The majority (59%) of survey responders were diagnosed with COVID-19 between November and December of 2020.
The estimated prevalence of long COVID among the population was 29.9%, with its occurrence most common in those aged 30 to 59 years, Hispanic individuals, women, and those insured by Medicaid.
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The study provides insight into groups of symptoms associated with a person not returning to their pre-COVID state of health.
In patients who developed long COVID, most (77.2%) indicated they had not returned to their pre-COVID-19 state of health within the 8 to 60 weeks following initial infection. The number of patients in this group who reported they had not returned to their previous physical state of health within this timeframe was higher than those who reported they had not returned to their previous mental state of health (77.1% vs 52.8%).
In the adjusted analysis, factors associated with increased risk for long COVID were as follows:
- Hospitalization for acute symptoms (adjusted odds ratio [aOR], 3.69; 95% CI, 2.2-6.1);
- Receipt of outpatient care for acute symptoms (aOR, 3.0; 95% CI, 2.3-3.7);
- Number of comorbidities (≥3; aOR, 1.8; 95% CI, 1.3-2.5); and,
- Female sex (aOR, 1.6; 95% CI, 1.3-2.0).
The researchers identified 4 symptom clusters associated with long COVID. These included myalgic encephalomyelitis/chronic fatigue syndrome-like symptoms (Cluster 1), changes in taste or smell (Cluster 2), gastrointestinal symptoms (Cluster 3), and upper respiratory symptoms (Cluster 4). For patients with long COVID, the risk of not returning to a pre-COVID-19 state of physical health was significantly higher among those who reported symptoms of Cluster 1 (aOR, 4.3; 95% CI, 3.0-6.1) and Cluster 4 (aOR, 1.7; 95% CI, 1.2-2.6). In contrast, Cluster 2, Cluster 3, and other long COVID symptoms were not significant factors for returning to usual state of health.
Similar findings were observed in regard to factors associated with returning to a pre-COVID-19 state of mental health.
Study limitations include the lack of a comparator group, possible response and nonresponse bias, potential misclassification, and the low survey response rate (10%).
According to the researchers, “The study provides insight into groups of symptoms associated with a person not returning to their pre-COVID state of health.”
This article originally appeared on Infectious Disease Advisor
