Long COVID in hospitalized and non-hospitalized patients in a large cohort in Northwest Spain, a prospective cohort study

  1. Alexandre Pérez-González
  2. Alejandro Araújo-Ameijeiras
  3. Alberto Fernández-Villar
  4. Manuel Crespo
  5. Eva Poveda
  6. the Cohort COVID-19 of the Galicia Sur Health Research Institute
  7. Jorge Julio Cabrera
  8. Víctor del Campo
  9. Beatriz Gil de Araujo
  10. Carlos Gómez
  11. Virginia Leiro
  12. María Rebeca Longueira
  13. Ana López-Domínguez
  14. José Ramón Lorenzo
  15. María Marcos
  16. María Teresa Pérez
  17. Lucia Patiño
  18. Sonia Pérez
  19. Silvia Pérez-Fernández
  20. Cristina Ramos
  21. Benito Regueiro
  22. Cristina Retresas
  23. Tania Rivera
  24. Olga Souto
  25. Isabel Taboada
  26. Susana Teijeira
  27. María Torres
  28. Vanesa Val
  29. Irene Viéitez

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Abstract

Survivors to COVID-19 have described long-term symptoms after acute disease. These signs constitute a heterogeneous group named long COVID or persistent COVID . The aim of this study is to describe persisting symptoms 6 months after COVID-19 diagnosis in a prospective cohort in the Northwest Spain. This is a prospective cohort study performed in the COHVID-GS. This cohort includes patients in clinical follow-up in a health area of 569,534 inhabitants after SARS-CoV-2/COVID-19 diagnosis. Clinical and epidemiological characteristics were collected during the follow up. A total of 248 patients completed 6 months follow-up, 176 (69.4%) required hospitalization and 29 (10.2%) of them needed critical care. At 6 months, 119 (48.0%) patients described one or more persisting symptoms. The most prevalent were: extra-thoracic symptoms (39.1%), chest symptoms (27%), dyspnoea (20.6%), and fatigue (16.1%). These symptoms were more common in hospitalized patients (52.3% vs. 38.2%) and in women (59.0% vs. 40.5%). The multivariate analysis identified COPD, women gender and tobacco consumption as risk factors for long COVID. Persisting symptoms are common after COVID-19 especially in hospitalized patients compared to outpatients (52.3% vs. 38.2%). Based on these findings, special attention and clinical follow-up after acute SARS-CoV-2 infection should be provided for hospitalized patients with previous lung diseases, tobacco consumption, and women.

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  1. Version published to 10.1038/s41598-022-07414-x
  2. ScreenIT

    SciScore for 10.1101/2021.08.05.21261634: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethics: This project was approved by the Ethical Committee of Pontevedra-Vigo-Ourense (reference 2021/184).
    Consent: All the patients included in the study belong to the COHVID-GS, which signed an informed consent form at the time of inclusion in the cohort.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    COHVID-GS also includes data about comorbidities, smoke status, weight and height.
    COHVID-GS
    suggested: None
    Statistical analyses were performed with IBM Statistical Product and Service Solutions (SPSS) program, version 22.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has few limitations. Firstly, some of the symptoms reported are subjective and based on the patient’s testimony (e.g. fatigue, headache, dyspnoea). Additionally, the lack of validated scales to measure most of the symptoms makes difficult to compare data between subjects or studies. Secondly, most of the symptoms may be affected by personal, psychological or environmental factors. We needed to use a non-validated custom questionnaire, as there is not a specific post-COVID-19 document established. Many symptoms could be higher reported in one group than another for unrelated reasons with coronavirus disease. This is the case for hair loss that may be more noticed in women and therefore more reported, leading to a possible increase of the prevalence in female subjects. In addition, previous comorbidities and age could increase the persisting symptoms in the hospitalized group. For COPD patients, we did not record symptoms that started before COVID-19 diagnosis. Therefore, it is possible that COPD patients reported more frequently chest or respiratory symptoms.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.08.05.21261634v1 on medRxiv