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Predictors of Long COVID in Patients without Comorbidities: Data from the Polish Long-COVID Cardiovascular
Michał Chudzik1, Joanna Lewek2,3, Joanna Kapusta4
1Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland.
Insights
A severe COVID-19 course, higher body mass index (BMI), and joint pain during acute infection predict Long COVID (LC) in patients without prior health conditions. These factors are key indicators for Long COVID risk assessment.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic presents a significant global health challenge.
- Understanding Long COVID (LC) risk factors in individuals without comorbidities is crucial.
- This study investigates predictors of LC in a healthy patient cohort.
Purpose of the Study:
- To identify predictors of Long COVID (LC) in patients without pre-existing comorbidities.
- To assess the association between acute COVID-19 severity and LC development.
- To evaluate the role of demographic and clinical factors in LC risk.
Main Methods:
- Prospective follow-up of 701 patients for at least 3 months post-COVID-19 recovery.
- Data collection included patient information, acute symptoms, and post-COVID-19 complaints.
- Diagnostic tools: ECG, 24-h ECG and BP monitoring, echocardiography, biochemical tests; LC defined by WHO criteria.
Main Results:
- Long COVID (LC) was observed in 218 of 488 patients completing follow-up (45%).
- A severe acute COVID-19 course was linked to higher LC incidence (34% vs. 19%).
- Independent predictors for LC included higher BMI (OR: 1.06), severe COVID-19 (OR: 1.74), and acute arthralgia (OR: 1.90).
Conclusions:
- Severe acute COVID-19, elevated BMI, and acute-phase joint pain are significant independent risk factors for developing Long COVID.
- These findings aid in identifying at-risk individuals among healthy populations.
- Further research into the mechanisms underlying these associations is warranted.
Abstract:
Background: The SARS-CoV-2 pandemic has become an enormous worldwide challenge over the last two years. However, little is still known about the risk of Long COVID (LC) in patients without comorbidities. Thus, we aimed to assess the predictors of LC in patients without comorbidities. Methods: Patients’ information, the course of the disease with symptoms, and post-COVID-19 complaints were collected within 4−12 weeks after COVID-19 recovery. Next, the patients were followed for at least 3 months. ECG, 24-h ECG monitoring, 24-h blood pressure (BP) monitoring, echocardiography, and selected biochemical tests were performed. LC was recognized based on the WHO definition. Results: We identified 701 consecutive patients, 488 of whom completed a 3-month follow-up (63% women). Comparisons were made between the LC group (n = 218) and patients without any symptoms after SARS-CoV-2 recovery (non-LC group) (n = 270). Patients with a severe course of acute-phase COVID-19 developed LC complications more often (34% vs. 19%, p < 0.0001). The persistent symptoms were observed in 45% of LC patients. The LC group also had significantly more symptoms during the acute phase of COVID-19, and they suffered significantly more often from dyspnoea (48 vs. 33%), fatigue (72 vs. 63%), chest pain (50 vs. 36%), leg muscle pain (41 vs. 32%), headache (66 vs. 52%), arthralgia (44 vs. 25%), and chills (34 vs. 25%). In LC patients, significant differences regarding sex and body mass index were observed—woman: 69% vs. 56% (p = 0.003), and BMI: 28 [24−31] vs. 26 kg/m2 [23−30] (p < 0.001), respectively. The number of symptoms in the acute phase was significantly greater in the LC group than in the control group (5 [2−8] vs. 2 [1−5], p = 0.0001). The LC group also had a higher 24-h heart rate (77 [72−83] vs. 75 [70−81], p = 0.021) at admission to the outpatient clinic. Multivariate regression analysis showed that LC patients had a higher BMI (odds ratio (OR): 1.06, 95% confidence intervals [CI]: 1.02−1.10, p = 0.007), almost twice as often had a severe course of COVID-19 (OR: 1.74, CI: 1.07−2.81, p = 0.025), and presented with joint pain in the acute phase (OR: 1.90, CI: 1.23−2.95, p = 0.004). Conclusions: A severe course of COVID-19, BMI, and arthralgia are independently associated with the risk of Long COVID in healthy individuals.
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