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Risk of Sequelae Following COVID-19 Infection: A Nationwide Study Focusing on Risk Factors and Long-Term Impacts
Simon Kjeldsen1, Jan Nielsen2,3, Bente Mertz Nørgård2,3
1Department of Pediatrics and Adolescent Medicine, Odense University Hospital, 5000 Odense, Denmark.
Journal of Clinical Medicine
|November 27, 2025
Summary
Sequelae of COVID-19 (long-term symptoms) affect 0.55% of adults over 40. Higher comorbidity scores increase risk, leading to significant long-term complications like blood clots and lung disease.
Area of Science:
- * Infectious Diseases
- * Public Health
- * Epidemiology
Background:
- * The SARS-CoV-2 pandemic caused widespread illness, with many patients experiencing prolonged symptoms, termed sequelae of COVID-19.
- * These sequelae are hypothesized to stem from systemic inflammation and immune dysregulation, affecting multiple organ systems.
- * Understanding the prevalence, risk factors, and long-term health impacts of COVID-19 sequelae is crucial for patient management.
Purpose of the Study:
- * To investigate the prevalence and risk factors associated with sequelae of COVID-19 in adults over 40.
- * To assess the long-term health outcomes and complications in individuals diagnosed with COVID-19 sequelae.
Main Methods:
- * A population-based cohort study utilizing Danish healthcare databases.
- * Inclusion of 1,034,093 individuals aged 40+ who tested positive for COVID-19 between March 2020 and February 2022.
- * Analysis of sequelae risk based on the Charlson Comorbidity Index (CCI) and assessment of two-year outcomes.
Main Results:
- * Prevalence of sequelae of COVID-19 was 0.55% across both age groups (40-59 and 60+).
- * Higher CCI scores were significantly correlated with an increased risk of developing COVID-19 sequelae.
- * Patients with sequelae of COVID-19 exhibited substantially elevated risks for thromboembolic events (HR 14.50/12.50), chronic lung diseases (HR 33.81/9.83), and infections (HR 8.40/15.44) over two years.
Conclusions:
- * While overall prevalence is low, individuals over 40 with higher comorbidity burdens face a greater risk of severe COVID-19 sequelae.
- * Significant long-term health complications, including cardiovascular, pulmonary, and infectious issues, are associated with COVID-19 sequelae.
- * Clinical monitoring is essential for patients with pre-existing conditions to mitigate the long-term health risks of COVID-19 sequelae.
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