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Association Between Acute COVID-19 Infection and Long COVID in a Non-Hospitalized Population: A Retrospective
Nicolás Escrivá1,2, Laura Moreno-Galarraga3,4, Elena Barado5
1Department of Occupational Medicine Complejo Hospitalario de Navarra Navarra Spain.
Health Science Reports
|August 21, 2025
Summary
Severe acute COVID-19 increases Long COVID risk. More symptoms during initial infection, especially dyspnea and chest pain, significantly raise the odds of developing Long COVID and functional impairment.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Long COVID (LC) presents persistent symptoms post-SARS-CoV-2 infection, with unclear pathophysiology.
- Identifying acute-phase risk factors is crucial for understanding LC development.
- This study focuses on non-hospitalized individuals to assess acute symptom impact on LC risk.
Purpose of the Study:
- Investigate the association between acute COVID-19 symptoms and Long COVID risk.
- Evaluate the impact of Long COVID on functional status in a non-hospitalized cohort.
- Identify specific acute symptoms that predict Long COVID development.
Main Methods:
- Retrospective observational case-control study (May 2022-March 2024) with 434 participants.
- Classified participants into Long COVID cases (n=226) and controls (n=208).
- Collected sociodemographic, clinical, and lifestyle data; assessed acute symptom severity and functional status (PCFS Scale); used regression analyses.
Main Results:
- Severe acute COVID-19 (pneumonia/hospitalization) significantly increased LC risk (aOR=7.22).
- Each additional acute symptom raised LC odds by 52% (aOR=1.52).
- Dyspnea and chest pain were the most strongly associated acute symptoms with Long COVID.
Conclusions:
- Acute COVID-19 severity and symptom burden are linked to Long COVID development.
- These factors also correlate with long-term functional impairment.
- Early identification and follow-up are vital for patients with severe initial COVID-19 symptoms.
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