Spain: Long COVID-19 Study

The COVID-19 virus has altered the course of history during the past two years. Further most significant observation is the emergence or persistence of symptoms after the acute phase of SARS-CoV-2 infection which is called long COVID-19 or post–COVID-19.

Researchers have found in a new study that Long COVID-19 symptoms were similar in hospitalized and nonhospitalized patients 2 years after infection. Further since post-COVID-19 symptoms were the same in hospitalized and non-hospitalized patients suggests that these sequelae should be taken seriously among all COVID-19 patients.

The study has been published in JAMA Network Open.

"In recent research, follow-up intervals of up to 6 months after acute infection were included in direct comparisons of hospitalized vs. nonhospitalized individuals. There is still a shortage of data for follow-up periods longer than a year following SARS-CoV-2 infection," said a team led by Cesar Fernández-de-las-Peñas.

Therefore, the primary goal of this study was to examine the presence of post-COVID-19 symptoms at a 2-year follow-up between patients who were hospitalized and those who were not. Finding possible risk factors in both hospitalized and outpatient COVID-19 patients for the emergence of post-COVID-19 symptoms two years after acute infection was the secondary goal.

For this purpose, between March 20 and April 30, 2020, 360 hospitalized patients and 308 non-hospitalized patients with acute SARS-CoV-2 infection participated in a cross-sectional cohort research at two urban hospitals and general practice clinics. A follow-up was done after two years. A telephone interview with the participants was planned for 2 years following the acute infection. Systematically evaluating the occurrence of post-COVID-19 symptoms was done with a focus on symptoms that appeared after infection. Medical records were mined for information on hospitalization and clinical outcomes. Researchers performed multivariate logistic regressions and between-group comparisons.

Key Highlights of the Research:

• Anosmia was more common among non-hospitalized patients than hospitalized patients (66 [21.4%] vs 36 [10.0%]; P =.003), but dyspnea was more common among hospitalized patients than non-hospitalized patients (112 [31.1%] vs 36 [11.7%]; P <.001).
• Patients who were hospitalized were evaluated at a mean (SD) of 23.8 (0.6) months following hospital discharge, while patients who were not hospitalized were evaluated at a mean (SD) of 23.4 (0.7) months following the onset of symptoms.
• At least 1 post-COVID-19 symptom was present in 215 (59.7%) of hospitalized patients and 208 (67.5%) of non-hospitalized patients two years after infection (P =.01).
• The three most common post-COVID-19 symptoms, 2 years after SARS-CoV-2 infection, were 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%]).
• There were no discernible variations in post-COVID-19 symptoms between hospitalized and outpatient individuals.
• Post-COVID-19 fatigue and dyspnea among hospitalized patients were also correlated with the number of comorbid medical conditions (odds ratio [OR], 1.93; 95% CI, 1.09-3.42; P =.02).
• Post-COVID-19 fatigue among non-hospitalized patients was linked with the number of preexisting medical comorbidities (OR, 3.75; 95% CI, 1.67-8.42; P =.001) and the number of symptoms at the time of illness (OR, 3.84; 95% CI, 1.33-11.05; P =.01).

Although post-COVID-19 symptoms were comparable in hospitalized and non-hospitalized patients, it is difficult to determine whether SARS-CoV-2 infection is linked to both general and particular post-COVID-19 symptoms two years after acute infection due to the exclusion of uninfected controls. Virus-free control populations should be used in future investigations, concluded the authors.

Regardless of whether the patient has been hospitalized or not, the latest research suggests that long-term COVID will need special management care.

Reference

Fernández-de-las-Peñas C, Rodríguez-Jiménez J, Cancela-Cilleruelo I, et al. Post–COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients. JAMA Netw Open. 2022;5(11):e2242106. doi:10.1001/jamanetworkopen.2022.42106