Persistent symptoms and risk factors predicting prolonged time to symptom-free after SARS‑CoV‑2 infection: an analysis of the baseline examination of the German COVIDOM/NAPKON-POP cohort
Open Access
- 25 May 2023
- journal article
- research article
- Published by Springer Science and Business Media LLC in Infection
- Vol. 51 (6), 1679-1694
- https://doi.org/10.1007/s15010-023-02043-6
Abstract
Purpose We aimed to assess symptoms in patients after SARS-CoV-2 infection and to identify factors predicting prolonged time to symptom-free. Methods COVIDOM/NAPKON-POP is a population-based prospective cohort of adults whose first on-site visits were scheduled ≥ 6 months after a positive SARS-CoV-2 PCR test. Retrospective data including self-reported symptoms and time to symptom-free were collected during the survey before a site visit. In the survival analyses, being symptom-free served as the event and time to be symptom-free as the time variable. Data were visualized with Kaplan–Meier curves, differences were tested with log-rank tests. A stratified Cox proportional hazard model was used to estimate adjusted hazard ratios (aHRs) of predictors, with aHR < 1 indicating a longer time to symptom-free. Results Of 1175 symptomatic participants included in the present analysis, 636 (54.1%) reported persistent symptoms after 280 days (SD 68) post infection. 25% of participants were free from symptoms after 18 days [quartiles: 14, 21]. Factors associated with prolonged time to symptom-free were age 49–59 years compared to < 49 years (aHR 0.70, 95% CI 0.56–0.87), female sex (aHR 0.78, 95% CI 0.65–0.93), lower educational level (aHR 0.77, 95% CI 0.64–0.93), living with a partner (aHR 0.81, 95% CI 0.66–0.99), low resilience (aHR 0.65, 95% CI 0.47–0.90), steroid treatment (aHR 0.22, 95% CI 0.05–0.90) and no medication (aHR 0.74, 95% CI 0.62–0.89) during acute infection. Conclusion In the studied population, COVID-19 symptoms had resolved in one-quarter of participants within 18 days, and in 34.5% within 28 days. Over half of the participants reported COVID-19-related symptoms 9 months after infection. Symptom persistence was predominantly determined by participant’s characteristics that are difficult to modify.Keywords
Funding Information
- China Scholarship Council (202108140048)
- Ludwig-Maximilians-Universität München
This publication has 38 references indexed in Scilit:
- COVID-19 rapid guideline: managing the long-term effects of COVID-192020
- Persistent symptoms 1.5–6 months after COVID-19 in non-hospitalised subjects: a population-based cohort studyThorax, 2020
- Long COVID in the Faroe Islands: A Longitudinal Study Among Nonhospitalized PatientsClinical Infectious Diseases, 2020
- Assessment and characterisation of post‐COVID‐19 manifestationsInternational Journal of Clinical Practice, 2020
- Survival AnalysisPublished by Springer Science and Business Media LLC ,2012
- Multiple imputation by chained equations: what is it and how does it work?International Journal of Methods in Psychiatric Research, 2011
- Job characteristics as mediators in SES–health relationshipsSocial Science & Medicine (1982), 2004
- Obesity: preventing and managing the global epidemic. Report of a WHO consultation.2000
- Generalized Collinearity DiagnosticsJournal of the American Statistical Association, 1992
- Evaluating the Yield of Medical TestsJAMA, 1982