Predictors of post-COVID-19 and the impact of persistent symptoms in non-hospitalized patients 12 months after COVID-19, with a focus on work ability
Keywords:
Post-COVID-19, long-term symptoms after COVID-19, work ability after COVID-19, healthcare workers
Abstract
Background: Better knowledge of long-term symptoms following coronavirus disease 2019 (COVID-19), the so-called post-COVID-19, in non-hospitalized patients is needed. The aim of this study was to study persisent symptoms up to 12 months after COVID-19 in non-hospitalized patients and their impact on work ability. We also investigated predictors of persistent symptoms.
Methods: This study encompassed non-hospitalized adult subjects with a COVID-19 infection confirmed via positive nasopharyngeal swab polymerase chain reaction test during the first wave of the pandemic in Uppsala, Sweden. In total, 566 subjects were sent a survey via e-mail or post with an invitation to participate in the survey 12 months post-diagnosis. The majority of subjects were healthcare workers, as this group was prioritized for testing.
Results: A total of 366 subjects responded, with 47% reporting persistent symptoms 12 months after their COVID-19 diagnosis. The most commonly reported symptoms at this time were impaired sense of smell and/or taste and fatigue. Among the predictors of persistent symptoms were being born abroad, lower physical fitness compared with peers before COVID-19, body mass index >25 kg/m2, cooccurrence of hypertension and chronic pain, and having more than seven of the general COVID-19 symptoms at the onset. Respondents with symptoms after 12 months self-reported negatively about their general health and work ability.
Conclusions: This study indicated that many people who had mild COVID-19 might have a variety of long-term symptoms. It highlights the importance of considering work ability after mild COVID-19.
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References
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32. Petersen MS, Kristiansen MF, Hanusson KD, Danielsen ME, Bjarni AS, Gaini S, et al. Long COVID in the Faroe Islands - a longitudinal study among non-hospitalized patients. Clin Infect Dis 2020;73:e4058–e4063. doi: 10.1093/cid/ciaa1792
2. Dennis A, Wamil M, Alberts J, Oben J, Cuthbertson DJ, Wootton D, et al. Multiorgan impairment in low-risk individuals with post-COVID-19 syndrome: a prospective, community-based study. BMJ Open 2021;11:e048391. doi: 10.1101/2020.10.14.20212555
3. Iqbal FM, Lam K, Sounderajah V, Clarke JM, Ashrafian H, Darzi A. Characteristics and predictors of acute and chronic post-COVID syndrome: a systematic review and meta-analysis. EClinicalMedicine 2021;36:100899. doi: 10.1016/j.eclinm.2021.100899
4. Viet-thi T, Porcher R, Pane I, Ravaus P. Course of post COVID-19 disease symptoms over time in the ComPaRe long COVID prospective e-cohort. Nat Communication 2022;13:1812. doi: 10.1038/s41467-022-29513-z
5. Carfi A, Bernabei R, Landi F. Gemelli against C-P-ACSG. Persistent symptoms in patients after acute COVID-19. JAMA 2020;324:603–605. doi: 10.1001/jama.2020.12603
6. Carvalho-Schneider C, Laurent E, Lemaignen A, Beaufils E, Bourbao-Tournois C, Laribi S, et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect 2021;27:258–263. doi: 10.1001/jama.2020.12603
7. Fernandez-De-Las-Penas C, Palacios-Cena D, Gomez-Mayordomo V, Florencio LL, Cuadrado ML, Plaza-Manzano G, et al. Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: a systematic review and meta-analysis. Eur J Intern Med 2021;92:55–70. doi: 10.1016/j.ejim.2021.06.009
8. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020;323:1239–1242. doi: 10.1001/jama.2020.2648
9. Wynberg E, Van Willigen HDG, Dijkstra M, Boyd A, Kootstra NA, Van Den Aardweg JG, et al. Evolution of COVID-19 symptoms during the first 12 months after illness onset. Clin Infect Dis 2021:ciab759. doi: 10.1101/2021.05.05.21256710
10. Boscolo-Rizzo P, Guida F, Polesel J, Marcuzzo AV, Capriotti V, D’Alessandro A, et al. Sequelae in adults at 12 months after mild-to-moderate coronavirus disease 2019 (COVID-19). Int Forum Allergy Rhinol 2021;11:1685–1688. doi: 10.1002/alr.22832
11. Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re’em Y, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicin. 2021;38:101019. doi: 10.1016/j.eclinm.2021.101019
12. Havervall S, Rosell A, Phillipson M, Mangsbo SM, Nilsson P, Hober S, et al. Symptoms and functional impairment assessed 8 months after mild COVID-19 among health care workers. JAMA 2021;325:2015–2016. doi: 10.1001/jama.2021.5612
13. Kisiel MA. Nordqvist T, Westman G, Svartegren M, Malinovschi A, Janols H. Patterns and predictors of sick leave among Swedish non-hospitalized healthcare and residential care workers with Covid-19 during the early phase of the pandemic. PLoS One 2021;16:e0260652. doi: 10.1371/journal.pone.0260652
14. Lyon JA, Garcia-Milian R, Norton HF, Tennant MR. The use of research electronic data capture (REDCap) software to create a database of librarian-mediated literature searches. Med Ref Serv Q 2014;33:241–252. doi: 10.1080/02763869.2014.925379
15. The National Institute for Health and Care Excellence (NICE). COVID-19 rapid guidelines, England, 2021, accessed 2022-07-25.
16. WHO/ISARIC. COVID-19 case record form. Global COVID-19: clinical platform. novel coronavirus (COVID-19) rapid version. 2020. Available from: https://apps.who.int/iris/handle/10665/331768, accessed 2022-07-25
17. SSYK2012. Standard för svensk yrkesklassificering 1996. 2012. Available from: https://www.scb.se/dokumentation/klassifikationer-och-standarder/standard-for-svensk-yrkesklassificering-ssyk/, accessed 2022-07-25
18. Bliddal S, Banasik K, Pedersen OB, Nissen J, Cantwell L, Schwinn M, et al. Acute and persistent symptoms in non-hospitalized PCR-confirmed COVID-19 patients. Sci Rep. 2021;11:13153. doi: 10.1038/s41598-021-92045-x
19. Fernandez-De-Las-Penas C, Palacios-Cena D, Gomez-Mayordomo V, Florencio LL, Cuadrado ML, Plaza-Manzano G, et al. Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: a systematic review and meta-analysis. Eur J Intern Med 2021;92:55–70. doi: 10.1016/j.ejim.2021.06.009
20. Augustin M, Schommers P, Stecher M, Dewald F, Gieselmann L, Gruell H, et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Eur 2021;6:100122. doi: 10.1016/j.lanepe.2021.100122
21. Einvik G, Dammen T, Ghanima W, Heir T, Stavem K. Prevalence and risk factors for post-traumatic stress in hospitalized and non-hospitalized COVID-19 patients. Int J Environ Res Public Health 2021;18:2079. doi: 10.3390/ijerph18042079
22. Karmakar M, Lantz PM, Tipirneni R. Association of social and demographic factors with COVID-19 incidence and death rates in the US. JAMA Netw Open 2021;4:e2036462. doi: 10.1001/jamanetworkopen.2020.36462
23. Drefahl S, Wallace M, Mussino E, Aradhya S, Kolk M, Branden M, et al. A population-based cohort study of socio-demographic risk factors for COVID-19 deaths in Sweden. Nat Commun 2020;11:5097. doi: 10.1038/s41467-020-18926-3
24. Aminian A, Bena J, Pantalone KM, Burguera B. Association of obesity with postacute sequelae of COVID-19. Diabetes Obes Metab. 2021;23:2183–2188. doi: 10.1111/dom.14454
25. Augustin M, Lehmann C. Post-COVID syndrome: turning convalescence into illness? – Authors’ reply. Lancet Reg Health Eur 2021;7:100170. doi: 10.1016/j.lanepe.2021.100170
26. Sjogren L, Stenberg E, Thuccani M, Martikainen J, Rylander C, Wallenius V, et al. Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden-A cohort study. PLoS One 2021;16:e0257891. doi: 10.1371/journal.pone.0257891
27. Fernandez-De-Las-Penas C, Torres-Macho J, Elvira-Martinez CM, Molina-Trigueros LJ, Sebastian-Viana T, Hernandez-Barrera V. Obesity is associated with a greater number of long-term post-COVID symptoms and poor sleep quality: a multicentre case-control study. Int J Clin Pract 2021;75:e14917. doi: 10.1111/ijcp.14917
28. Sallis R, Young DR, Tartof SY, Sallis JF, Sall J, Li Q, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Br J Sports Med 2021;55:1099–1105. doi: 10.1136/bjsports-2021-104080
29. Zhang X, Li X, Sun Z, He Y, Xu W, Campbell H, et al. Physical activity and COVID-19: an observational and Mendelian randomisation study J Glob Health 2020;10:020514. doi: 10.7189/jogh.10.020514
30. Matthews CE, Ockene IS, Freedson PS, Rosal MC, Merriam PA, Hebert JR. Moderate to vigorous physical activity and risk of upper-respiratory tract infection. Med Sci Sports Exerc 2002;34:1242–1248. doi: 10.1097/00005768-200208000-00003
31. Kuiper IN, Svanes C, Benediktsdottir B, Bertelsen RJ, Braback L, Dharmage SC, et al. Agreement in reporting of asthma by parents or offspring - the RHINESSA generation study. BMC Pulm Med 2018;18:122. doi: 10.1186/s12890-018-0687-4
32. Petersen MS, Kristiansen MF, Hanusson KD, Danielsen ME, Bjarni AS, Gaini S, et al. Long COVID in the Faroe Islands - a longitudinal study among non-hospitalized patients. Clin Infect Dis 2020;73:e4058–e4063. doi: 10.1093/cid/ciaa1792
Published
2022-08-09
How to Cite
Kisiel M. A., Janols H., Nordqvist T., Bergquist J., Hagfeldt S., Malinovschi A., & Svartengren M. (2022). Predictors of post-COVID-19 and the impact of persistent symptoms in non-hospitalized patients 12 months after COVID-19, with a focus on work ability. Upsala Journal of Medical Sciences, 127(1). https://doi.org/10.48101/ujms.v127.8794
Section
Original Articles
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