Long COVID Symptoms 1 Year After Onset More Likely in Older Adults, Women

Results of a cross-sectional study published in JAMA Network Open found that approximately 10% of patients experience persistent COVID-19 symptoms 1 year after the onset of infection, suggesting long COVID is a public health concern.

Patient data for this study were sourced from 3 population-based cohorts in France. Patients (N=3972) who tested positive for COVID-19 infection and experienced symptoms between May and November 2020 were invited to respond to an internet-based follow-up questionnaire between June and September 2021. Researchers assessed factors associated with the occurrence of long COVID symptoms at 1 year following the acute phase of infection. Persistent symptoms were considered those that occurred during acute infection for a duration of 2 months or longer.

Among patients included in the analysis, the mean (SD) age was 50.9 (12.7) years, 63.7% were women, 48.1% had a history of cigarette smoking, 6.5% had chronic respiratory disease, 4.1% had cancer, and 2.4% had generalized anxiety disorder (GAD) or major depressive disorder (MDD). The overall patient population reported a mean (SD) of 3.1 (3.2) COVID-19-related symptoms during the acute phase of infection.

A total of 2647 (66.6%) patients reported at least 1 symptom during the acute phase of COVID-19 infection. Of these patients, 861 (32.5%) reported persistent symptoms for 2 months or longer following the onset of infection. Compared with patients (n=3111) without persistent symptoms, those with persistent symptoms were more likely to be women, have a history of smoking, and report an increased number of symptoms during the acute phase of infection. Patients with persistent symptoms also were more likely to have chronic respiratory disease, cancer, and GAD or MDD.

The most common symptoms during the acute phase of COVID-19 infection were asthenia (46.1%), fever (39.8%), headache (36.7%), and myalgia (33.6%). The most common symptoms persisting beyond 2 months of infection onset were memory loss (40.0%) and sleep disorders (36.6%).

A multivariable analysis was performed to determine risk factors associated with persistent COVID-19 symptoms. Significant risk factors for long COVID symptoms after 1 year included the occurrence of 5 or more symptoms during the acute phase of infection (adjusted hazard ratio [aHR], 0.45; 95% CI, 0.41-0.50; P <.001), female sex (aHR, 0.67; 95% CI, 0.61-0.75; P <.001), cancer (aHR, 0.68; 95% CI, 0.52-0.90; P =.007), older age (>60 years; aHR, 0.79; 95% CI, 0.67-0.92; P =.003), and high BMI (³30 kg/m²; aHR, 0.82; 95% CI, 0.68-0.97; P =.03).

Limitations include potential recall and misclassification bias. These results also may not be generalizable to other patient populations.

“[T]hese findings suggest the need to optimally manage comorbid conditions in individuals with long COVID to help reduce the duration of their symptoms,” the researchers concluded.

Disclosure: Multiple authors declared affiliations with industry. Please see the original reference for a full list of disclosures.