The prevalence of post-Covid syndrome symptoms depended on the severity of the acute phase of the disease

An international group of researchers studied the course of post-Covid syndrome in a large population of people living in Scandinavian countries. The long-term risk of severe physical symptom burden was clearly associated with the severity of the acute phase of illness for two years or more after diagnosis.

Dr. Qing Shen from the Center for Clinical Research of Mental Disorders at Tongji University School of Medicine in Shanghai, in collaboration with scientists from major medical centers and medical institutes in four Scandinavian countries, conducted a large-scale epidemiological study of post-Covid syndrome on a combined cohort of people living in Iceland, Sweden, Norway and Denmark. The results were published in THE LANCET.

During the 27-month follow-up period, 22,382 (34.5%) of 64,880 participants were diagnosed with acute COVID-19. The prevalence of severe somatic symptoms (PHQ-15 score 15 or more) observed for more than two years among those who experienced the acute phase of the disease was 37% or more higher than among participants who did not have COVID-19. The relationship between the prevalence of eight severe somatic symptoms and the severity of the acute phase of COVID-19 was determined. The highest prevalence of symptoms was observed in 9.6% of participants who were on bed rest for seven days or more during the acute phase. A statistically significant prevalence of symptoms such as shortness of breath, chest pain, dizziness, tachycardia, headache, loss of strength/fatigue, sleep disturbances and back pain was determined. The prevalence of severe physical symptoms was similar among people diagnosed with COVID-19 who were not on bed rest and those without COVID-19. The association between the prevalence of severe symptoms and acute phase severity was independent of gender, age, COVID-19-related depressive and anxiety symptoms, and pre-existing medical comorbidities. Over time, no clear reduction in the prevalence of most symptoms was observed, with the exception of dizziness.

The multinational observational study included 64,880 adult participants from four COVIDMENT Consortium cohorts: the Icelandic National COVID-19 Resistance Registry, the Swedish Omtanke 2020 Study, the Norwegian COVID-19 Project and the Danish Blood Donor Study between April 2020 and August 2022. The dynamics of symptoms were assessed using the PHQ-15 questionnaire, which includes 15 symptoms, at established time points covering a period of up to 27 months. Additionally, symptom dynamics were assessed in a subgroup of Swedish adults using repeated assessments before and after COVID-19 diagnosis.

Among patients with COVID-19, 28% of participants were kept in bed during the acute phase of infection, of which 18.4% were kept for 1–6 days, 9.6% were kept for 7 days or more, and 1% of participants were hospitalized.

Severe acute phase of SARS-CoV-2 illness was a significant predictor of persistent physical symptoms such as shortness of breath, chest pain, headache and fatigue, indicating the importance of continuous monitoring of such patients for at least the first two years. years after diagnosis.

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