Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study

Oscar Moreno-Pérez; Esperanza Merino; Jose-Manuel Leon-Ramirez; Mariano Andres; Jose Manuel Ramos; Juan Arenas-Jiménez; Santos Asensio; Rosa Sanchez; Paloma Ruiz-Torregrosa; Irene Galan; Alexander Scholz; Antonio Amo; Pilar González-delaAleja; Vicente Boix; Joan Gil; COVID19-ALC research group

doi:10.1016/j.jinf.2021.01.004

Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study

J Infect. 2021 Mar;82(3):378-383. doi: 10.1016/j.jinf.2021.01.004. Epub 2021 Jan 12.

Authors

Oscar Moreno-Pérez¹, Esperanza Merino², Jose-Manuel Leon-Ramirez³, Mariano Andres⁴, Jose Manuel Ramos⁵, Juan Arenas-Jiménez⁶, Santos Asensio⁷, Rosa Sanchez⁸, Paloma Ruiz-Torregrosa³, Irene Galan³, Alexander Scholz⁹, Antonio Amo⁹, Pilar González-delaAleja⁹, Vicente Boix¹⁰, Joan Gil³; COVID19-ALC research group

Affiliations

¹ Endocrinology and Nutrition department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain; Clinical Medicine department, Miguel Hernández University, Elche, Spain. Electronic address: omorenoperez@hotmail.es.
² Unit of Infectious Diseases, Alicante General University Hospital, Alicante Institute of Health and Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: merino_luc@gva.es.
³ Pneumology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁴ Clinical Medicine department, Miguel Hernández University, Elche, Spain; Rheumatology department, Alicante General University Hospital Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁵ Clinical Medicine department, Miguel Hernández University, Elche, Spain; Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: jose.ramosr@umh.es.
⁶ Radiology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁷ Pneumology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: asensio_san@gva.es.
⁸ Neurology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: sanchez_ros@gva.es.
⁹ Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
¹⁰ Clinical Medicine department, Miguel Hernández University, Elche, Spain; Unit of Infectious Diseases, Alicante General University Hospital, Alicante Institute of Health and Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address: boix_vic@gva.es.

Abstract

Objectives: This study aims to analyze the incidence of Post-acute COVID-19 syndrome (PCS) and its components, and to evaluate the acute infection phase associated risk factors.

Methods: A prospective cohort study of adult patients who had recovered from COVID-19 (27th February to 29th April 2020) confirmed by PCR or subsequent seroconversion, with a systematic assessment 10-14 weeks after disease onset. PCS was defined as the persistence of at least one clinically relevant symptom, or abnormalities in spirometry or chest radiology. Outcome predictors were analyzed by multiple logistic regression (OR; 95%CI).

Results: Two hundred seventy seven patients recovered from mild (34.3%) or severe (65.7%) forms of SARS-CoV-2 infection were evaluated 77 days (IQR 72-85) after disease onset. PCS was detected in 141 patients (50.9%; 95%CI 45.0-56.7%). Symptoms were mostly mild. Alterations in spirometry were noted in 25/269 (9.3%), while in radiographs in 51/277 (18.9%). No baseline clinical features behaved as independent predictors of PCS development.

Conclusions: A Post-acute COVID-19 syndrome was detected in a half of COVID19 survivors. Radiological and spirometric changes were mild and observed in less than 25% of patients. No baseline clinical features behaved as independent predictors of Post-acute COVID-19 syndrome development.

Keywords: Associated factors; COVID-19; Cohort study; Diagnostic imaging; Health-related quality of life; Life quality; Sequelae; Spirometry; Symptoms; Syndrome.

MeSH terms

Adult
COVID-19*
Cohort Studies
Humans
Incidence
Prospective Studies
Risk Factors
SARS-CoV-2