Download This PaperQuality of Life and Long COVID Incidence and Duration in the First 24 Months after Mild to Moderate Acute COVID-19: The OutSMART Prospective Cohort Study
26 Pages Posted: 2 Mar 2023
Abstract
Background: Few longitudinal studies available characterize long COVID outcomes out to 24 months, especially in people with non-severe acute COVID-19.
Objectives: This study sought to prospectively characterize incidence and duration of long COVID symptoms and their association with quality of life from 1-24 months post-mild-to-moderate COVID-19 using validated tools in a diverse cohort of unvaccinated people infected with SARS-CoV-2 in 2020.
Study design: At 1-3, 6, 12, 18, and 24 months post-COVID-19, 70 participants provided blood and completed surveys characterizing symptoms, quality of life, and return to pre-COVID health and activities using validated tools (FLU-PRO+, FSS, ISI, GPCOG, PHQ-8, GAD-7, SF-36, EQ-5D-5L).
Results: During the study period, 33% of participants experienced long COVID (had not returned to pre-COVID health and reported at least one symptom >90 days after infection); 8% had not returned to their pre-COVID health 24 months post-infection. Long COVID symptoms were most common six months post-COVID-19 and frequently caused activity limitations. Having long COVID was significantly associated with decreased quality of life in multiple domains. Frequencies of orthostatic hypotension and tachycardia were similar to levels reported in the general population. Within-person weight increased significantly between months 1 and 6. Long COVID was associated with pre-COVID obesity and hyperlipidemia, but not with high-sensitivity C-reactive protein levels 1-3 months post-infection.
Conclusions: Long COVID occurs in a significant proportion of people, even if the acute illness was not severe. Long COVID prevalence peaked 6-12 months post-COVID, and a small proportion still report not regaining their pre-COVID health 24 months post-COVID.
Note:
Funding Information: This work was supported by the Henry M. Jackson Foundation for the Advancement of Military Medicine [1007957 to P.W.B. and Y.C.M.]; the Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases Discovery Program [to P.W.B. and Y.C.M.]; and the National Institute of Allergy and Infectious Diseases (K08AI143391 to A.A.R.A., K23AI135102 to 305 J.A.T.).
Declaration of Interests: Dr. Manabe has received research grant support to Johns Hopkins University from Hologic, Cepheid, Roche, ChemBio, Becton Dickinson, and miDiagnostics, and has provided consultative support to Abbott, none of which constitute a conflict of interest with this study. No other authors have commercial or financial relationships that could be construed as potential conflicts of interest.
Ethics Approval Statement: Informed consent was obtained from all participants; this study was approved by the Johns Hopkins University School of Medicine IRB.
Keywords: SARS-CoV-2, COVID-19, long covid, Longitudinal, Prospective Cohort, Quality of Life
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