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Trajectories of the Evolution of Post COVID-19 Condition, Up to Two Years after Symptoms Onset
13 Pages Posted: 20 Oct 2022
More...Abstract
Background: Post coronavirus-19 (COVID-19) condition is multifaceted with a heterogeneous clinical presentation. We aimed to identify distinct trajectories of the evolution of post COVID-19 condition, up to two years after symptom onset.
Methods: The ComPaRe long COVID e-cohort is a nationwide prospective cohort of adult patients with symptoms lasting at least two months after SARS-CoV2 infection. We used trajectory modelling to identify different trajectories of the evolution of post COVID-19 condition, based on 53 self-reported symptoms collected every 60 days using the long COVID Symptom Tool. We used regression analyses to identify the clinical characteristics associated with each trajectory.
Findings: A total of 2,197 patients were enrolled in the cohort between December 2020 and July 2022 (median age 46 years, interquartile range [IQR] 38–54 years; 79% women and 69% with laboratory- confirmed SARS-CoV-2 infection). Three distinct trajectories of the evolution of post COVID-19 condition were identified: “high persistent symptoms” (4%), “rapidly decreasing symptoms” (5%), and “slowly decreasing symptoms” (91%). Participants with high persistent symptoms were older and more likely to report a history of systemic diseases. They often reported tachycardia, bradycardia, palpitations, and arrhythmia, paraesthesia or hot flushes. Participants with rapidly decreasing symptoms were younger and more likely to report a confirmed infection. They often reported diarrhoea and, neck, back, and/or low back pain. Participants with slowly decreasing symptoms were more likely to have functional diseases.
Interpretation: Most of patients with post COVID-19 condition improve slowly over time, while 5% have rapid improvement in the two years after symptom onset and 4% have a persistent condition. Our results will help to better inform patients about their prognosis and warrant special focus on the response required by the healthcare system.
Funding: The authors received no specific funding for this study.
Declaration of Interest: The authors declare no competing interests or financial associations that may be relevant or seen as relevant to the submitted manuscript
Ethical Approval: The Institutional Review Board of Hôtel-Dieu Hospital, Paris (IRB 0008367) approved the ComPaRe cohort.
Keywords: COVID-19, long COVID, trajectory, prospective cohort, natural history, endotypes
Suggested Citation: Suggested Citation
