Post-COVID-19 symptom burden and recovery: a longitudinal study

Abstract

Purpose: Post-COVID-19 is an emergent and often debilitating condition, yet individual symptom burden and long-term evolution are still being explored. We aimed to study the burden and duration of post-COVID-19 condition, and assess its relation to sociodemographic characteristics, medical comorbidities, acute COVID-19 presentation, and vaccination status prior to infection. Methods: In this longitudinal study, we analysed data from 52 patients followed from March 2021 to September 2022 at a post-COVID-19 consultation in a tertiary hospital in Porto, Portugal. Results: The most frequently reported symptoms were fatigue (82.7%), physical impairment (75.0%), and altered memory (57.7%). Over sixty percent reported at least one symptom with a high burden on daily life. Patient-reported depression (p<0.01), among other mental illnesses (p<0.05), were identified as risk factors for higher symptom burden. The number of acute-phase symptoms was associated with the number of post-COVID-19 ones [beta=0.63, 95% CI (0.16, 1.09), p<0.01]. Eleven patients (21%) reported recovery of their previous health status, at an average of 12.5 months after infection. Conclusions: Although most patients did not fully recover after a one-year follow-up, most reported an improvement in their health status over time. Patients with a higher number of acute-phase symptoms were at increased risk of a higher number of persistent symptoms, and those with previous mental illness had a higher burden on daily life. The evaluation of patients' perception of recovery may give a more clinically relevant notion of the long-term effects of COVID-19, than merely relying on the quantification of persistent symptoms.