tetano
Editor, Senior Moderator
BMC Med
. 2025 Mar 14;23(1):140.
doi: 10.1186/s12916-025-03974-7. Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia
Manolis Kogevinas[SUP] #[/SUP][SUP] 1 2 3 4 [/SUP], Marianna Karachaliou[SUP] #[/SUP][SUP] 5 [/SUP], Ana Espinosa[SUP] 5 6 7 [/SUP], Susana Iraola-Guzmán[SUP] 8 9 [/SUP], Gemma Castaño-Vinyals[SUP] 5 6 7 [/SUP], Laura Delgado-Ortiz[SUP] 5 6 7 [/SUP], Xavier Farré[SUP] 8 9 [/SUP], Natàlia Blay[SUP] 8 9 [/SUP], Neil Pearce[SUP] 10 [/SUP], Magda Bosch de Basea[SUP] 5 [/SUP], Eva Alonso Nogués[SUP] 11 [/SUP], Carlota Dobaño[SUP] 5 12 [/SUP], Gemma Moncunill[SUP] 5 12 [/SUP], Rafael de Cid[SUP] 8 9 [/SUP], Judith Garcia-Aymerich[SUP] 5 6 7 [/SUP]
Affiliations
Background: Long-COVID has mostly been investigated in clinical settings. We aimed to assess the risk, subtypes, persistence, and determinants of long-COVID in a prospective population-based study of adults with a history of SARS-CoV-2 infection in Catalonia.
Methods: We examined 2764 infected individuals from a population-based cohort (COVICAT) established before the pandemic and followed up three times across the pandemic (2020, 2021, 2023). We assessed immunoglobulin (Ig)G levels against SARS-CoV-2, clinical, vaccination, sociodemographic, and lifestyle factors. Long-COVID risk and subtypes were defined based on participant-reported symptoms and electronic health records. We identified a total of 647 long-COVID cases and compared them with 2117 infected individuals without the condition.
Results: Between 2021 and 2023, 23% of infected subjects developed long-COVID symptoms. In 56% of long-COVID cases in 2021, symptoms persisted for 2 years. Long-COVID presented clinically in three subtypes, mild neuromuscular, mild respiratory, and severe multi-organ. The latter was associated with persistent long-COVID. Risk was higher among females, participants under 50 years, of low socioeconomic status, severe COVID-19 infection, elevated pre-vaccination IgG levels, obesity, and prior chronic disease, particularly asthma/chronic obstructive pulmonary disease and mental health conditions. A lower risk was associated to pre-infection vaccination, infection after omicron became the dominant variant, higher physical activity levels, and sleeping 6-8 h. Vaccination during the 3 months post-infection was also protective against long-COVID.
Conclusions: Long-COVID persisted for up to 2 years in half of the cases, and risk was influenced by multiple factors.
Keywords: COVID-19; Epidemiology; Exercise; Long-COVID; SARS-CoV-2 antibodies; Sleep; Vaccines.
. 2025 Mar 14;23(1):140.
doi: 10.1186/s12916-025-03974-7. Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia
Manolis Kogevinas[SUP] #[/SUP][SUP] 1 2 3 4 [/SUP], Marianna Karachaliou[SUP] #[/SUP][SUP] 5 [/SUP], Ana Espinosa[SUP] 5 6 7 [/SUP], Susana Iraola-Guzmán[SUP] 8 9 [/SUP], Gemma Castaño-Vinyals[SUP] 5 6 7 [/SUP], Laura Delgado-Ortiz[SUP] 5 6 7 [/SUP], Xavier Farré[SUP] 8 9 [/SUP], Natàlia Blay[SUP] 8 9 [/SUP], Neil Pearce[SUP] 10 [/SUP], Magda Bosch de Basea[SUP] 5 [/SUP], Eva Alonso Nogués[SUP] 11 [/SUP], Carlota Dobaño[SUP] 5 12 [/SUP], Gemma Moncunill[SUP] 5 12 [/SUP], Rafael de Cid[SUP] 8 9 [/SUP], Judith Garcia-Aymerich[SUP] 5 6 7 [/SUP]
Affiliations
- PMID: 40082863
- PMCID: PMC11907888
- DOI: 10.1186/s12916-025-03974-7
Background: Long-COVID has mostly been investigated in clinical settings. We aimed to assess the risk, subtypes, persistence, and determinants of long-COVID in a prospective population-based study of adults with a history of SARS-CoV-2 infection in Catalonia.
Methods: We examined 2764 infected individuals from a population-based cohort (COVICAT) established before the pandemic and followed up three times across the pandemic (2020, 2021, 2023). We assessed immunoglobulin (Ig)G levels against SARS-CoV-2, clinical, vaccination, sociodemographic, and lifestyle factors. Long-COVID risk and subtypes were defined based on participant-reported symptoms and electronic health records. We identified a total of 647 long-COVID cases and compared them with 2117 infected individuals without the condition.
Results: Between 2021 and 2023, 23% of infected subjects developed long-COVID symptoms. In 56% of long-COVID cases in 2021, symptoms persisted for 2 years. Long-COVID presented clinically in three subtypes, mild neuromuscular, mild respiratory, and severe multi-organ. The latter was associated with persistent long-COVID. Risk was higher among females, participants under 50 years, of low socioeconomic status, severe COVID-19 infection, elevated pre-vaccination IgG levels, obesity, and prior chronic disease, particularly asthma/chronic obstructive pulmonary disease and mental health conditions. A lower risk was associated to pre-infection vaccination, infection after omicron became the dominant variant, higher physical activity levels, and sleeping 6-8 h. Vaccination during the 3 months post-infection was also protective against long-COVID.
Conclusions: Long-COVID persisted for up to 2 years in half of the cases, and risk was influenced by multiple factors.
Keywords: COVID-19; Epidemiology; Exercise; Long-COVID; SARS-CoV-2 antibodies; Sleep; Vaccines.