Post–COVID-19 Symptoms 2 Years after COVID Infection among Hospitalized vs Nonhospitalized Patients
JAMA Network: November, 2022
After the worldwide outbreak
leading to millions of acute cases and thousands of deaths, another important
development is the occurrence or persistence of symptoms after the acute phase
of SARS-CoV-2 infection (ie, long COVID or post–COVID-19).
More than 100 post–COVID-19
symptoms affecting multiple systems (eg, cardiovascular, neurologic,
respiratory, and musculoskeletal) have been described. Evidence supports
that individuals exhibiting post–COVID-19 symptoms report worse health-related
quality of life.
TAKE-HOME MESSAGE
In this cross-sectional cohort
study, the authors compared the presence of post–COVID-19 symptoms 2 years
after SARS-CoV-2 infection between hospitalized and nonhospitalized patients.
At 2 years, there was no
significant difference between the two groups in the number of patients
reporting at least one post–COVID-19 symptom.
Fatigue, pain, and memory loss were
the most commonly reported symptoms at 2 years in both hospitalized and
nonhospitalized patients.
These results add to the growing
body of evidence that post–COVID-19 symptoms can remain present after 2 years
regardless of the initial severity of the infection.
A recent study has identified 4 different risk factors associated with SARS-CoV-2 acute infection (ie, presence of type 2 diabetes, SARS-CoV-2 RNAemia, Epstein-Barr virus viremia, and specific autoantibodies) that were associated with the development of long COVID symptoms.
Conclusions
This cross-sectional study
suggested the presence of at least 1 post–COVID-19 symptom in 59.7% of
hospitalized patients and 67.5% of nonhospitalized patients 2 years after
infection. Dyspnea was more prevalent among hospitalized patients, whereas
anosmia was more prevalent among nonhospitalized patients. Post–COVID-19
symptoms were similar between hospitalized and nonhospitalized patients.
Doctors Liked to Read More
IMPORTANCE
Identification of long-term
post-COVID-19 symptoms among hospitalized and nonhospitalized patients is
needed.
OBJECTIVE
To compare the presence of
post-COVID-19 symptoms 2 years after acute SARS-CoV-2 infection between
hospitalized and nonhospitalized patients.
DESIGN, SETTING, AND PARTICIPANTS
A cross-sectional cohort study was
conducted at 2 urban hospitals and general practitioner centers from March 20
to April 30, 2020, among 360 hospitalized patients and 308 nonhospitalized
patients with acute SARS-CoV-2 infection during the first wave of the pandemic.
Follow-up was conducted 2 years later.
MAIN OUTCOMES AND MEASURES
Participants were scheduled for a
telephone interview 2 years after acute infection. The presence of
post-COVID-19 symptoms was systematically assessed, with particular attention
to symptoms starting after infection. Hospitalization and clinical data were
collected from medical records. Between-group comparisons and multivariate
logistic regressions were conducted.
RESULTS
A total of 360 hospitalized patients
(162 women [45.0%]; mean [SD] age, 60.7 [16.1] years) and 308 nonhospitalized
patients (183 women [59.4%]; mean [SD] age, 56.7 [14.7] years) were included.
Dyspnea was more prevalent at the onset of illness among hospitalized than
among nonhospitalized patients (112 [31.1%] vs 36 [11.7%]), whereas anosmia was
more prevalent among nonhospitalized than among hospitalized patients (66
[21.4%] vs 36 [10.0%]). Hospitalized patients were assessed at a mean (SD) of
23.8 (0.6) months after hospital discharge, and nonhospitalized patients were
assessed at a mean (SD) of 23.4 (0.7) months after the onset of symptoms. The
number of patients who exhibited at least 1 post-COVID-19 symptom 2 years after
infection was 215 (59.7%) among hospitalized patients and 208 (67.5%) among nonhospitalized
patients. Among hospitalized and nonhospitalized patients, fatigue (161 [44.7%]
vs 147 [47.7%]), pain (129 [35.8%] vs 92 [29.9%]), and memory loss (72 [20.0%]
vs 49 [15.9%]) were the most prevalent post-COVID-19 symptoms 2 years after
SARS-CoV-2 infection. No significant differences in post-COVID-19 symptoms were
observed between hospitalized and nonhospitalized patients. The number of
preexisting medical comorbidities was associated with post-COVID-19 fatigue and
dyspnea among hospitalized patients. The number of preexisting medical
comorbidities and the number of symptoms at the onset of illness were
associated with post-COVID-19 fatigue among nonhospitalized patients.
CONCLUSIONS AND RELEVANCE
This cross-sectional study
suggested the presence of at least 1 post-COVID-19 symptom in 59.7% of
hospitalized patients and 67.5% of nonhospitalized patients 2 years after
infection. Small differences in symptoms at onset of COVID-19 were identified
between hospitalized and nonhospitalized patients. Post-COVID-19 symptoms were
similar between hospitalized and nonhospitalized patients; however, lack of
inclusion of uninfected controls limits the ability to assess the association
of SARS-CoV-2 infection with overall and specific post-COVID-19 symptoms 2
years after acute infection. Future studies should include uninfected control
populations.
Comments
You must login to write comment