Abstract:
COVID-19 has been associated with a broad range of long-term sequelae, commonly referred to as “long-COVID” or “post-COVID-19” syndrome. Despite an increasing body of literature, long COVID remains poorly characterized. We retrospectively analysed data from electronic medical records of patients admitted to the post-COVID-19 outpatient service of the Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy, between June 2020 and June 2021, 4-12 weeks after hospital discharge.
A total of 428 patients, 41% women, median age 64 years, underwent a follow-up visit a median 53 days after hospital discharge. Overall, 76% patients reported at least one persistent symptom, including dyspnoea (37%), chronic fatigue (36%), insomnia (16%), visual disorders (13%) and brain fog (13%). Increasing oxygen support (OR 1.4, 95% CI 1.1-1.8), use of immunosuppressants (OR 6.4, 95% CI 1.5-28) and female sex (OR 1.8, 95% CI 1.1-2.9) were associated with a higher risk of long COVID symptoms.
Comparison between symptomatic patients infected in the period March-December 2020 (prevalent circulation of wild-type SARS-CoV-2) with those infected in the period January-April 2021 (prevalent circulation of B.1.1.7 Alpha variant) showed a significant modification in the pattern of symptoms belonging to the neurological and cognitive/emotional categories.
Our findings confirmed shortness of breath and chronic fatigue as the most frequent long COVID manifestations, while female sex and severe COVID-19 course were the main risk factors for developing lingering symptoms. SARS-CoV-2 variants may induce different long COVID phenotypes, possibly due to changes in cell tropism and differences in viral-host interaction.
Source: Spinicci M, Graziani L, Tilli M, Nkurunziza J, Vellere I, Borchi B, Mencarini J, Campolmi I, Gori L, Giovannoni L, Amato C, Livi L, Rasero L, Fattirolli F, Marcucci R, Giusti B, Olivotto I, Tomassetti S, Lavorini F, Maggi L, Annunziato F, Marchionni N, Zammarchi L, Bartoloni A. Infection with SARS-CoV-2 Variants Is Associated with Different Long COVID Phenotypes. Viruses. 2022 Oct 27;14(11):2367. doi: 10.3390/v14112367. PMID: 36366465; PMCID: PMC9698829. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9698829/ (Full text)