Factors associated with persistence or recovery from long COVID 6 months post-SARS-CoV-2 infection

There are limited data on the illness trajectory for individuals with long COVID. We prospectively followed 1,234 individuals with long COVID at 3 months post-SARS-CoV-2 infection to identify factors associated with persistence or recovery. At 6 months post-infection, 724 (58.7%) had persistent long COVID and 510 (41.3%) had fully recovered. In multivariable analyses, pre-existing health conditions at the time of initial SARS-CoV-2 infection and reporting fatigue, shortness of breath, and cough 3 months post-infection were independent predictors of persistent long COVID. Age, sex, and number of COVID vaccinations were not significantly associated with persistent long COVID. For persons with persistent long COVID, the median number of symptoms remained stable over follow-up, indicating that there had been little symptomatic improvement. A third of those with persistent long COVID reported seeking medical care for their symptoms and a third had ceased or reduced their hours of work/study. Our findings suggest that there may be distinct clinical trajectories for long COVID observed between 3- and 6-month follow-up, that is, persons who experience full recovery and those with minimal clinical improvement, and this may have implications for management of affected individuals.