https://www.cidrap.umn.edu/covid-19...impaired-health-2-years-after-covid-infection
Studies note higher risk of death, impaired health up to 2 years after COVID infection
Mary Van Beusekom, MS
Today at 3:54 p.m.
COVID-19
A 'substantial cumulative burden'
Researchers from the Veterans Affairs Saint Louis Health Care System followed 138,818 US veterans (20,580 of them hospitalized and 118,238 not hospitalized) during their COVID-19 infections and 5,985,227 of their uninfected peers for 2 years to estimate their risk of death and 80 long-COVID symptoms.
The study was published yesterday in Nature Medicine.
The average age of the COVID-19 group was 60.9 years, and 11.4% were women. In the control group, the average age was 62.8 years, and 9.9% were women. Median follow-up time was 715 days in the infected group and 719 in the control group.
The increased risk of death was not significant beyond 6 months after infection among nonhospitalized veterans but was significantly elevated through 2 years in those admitted to the hospital. A total of 69% and 35% of the 80 long-COVID signs and symptoms became nonsignificant 2 years after infection in nonhospitalized and hospitalized veterans, respectively.
Among hospitalized veterans, risks at 2 years after infection remained increased for 65% of long-COVID signs and symptoms, including those involving the cardiovascular (57%), coagulation and hematologic (80%), endocrine (100%), gastrointestinal (82%), renal (75%), musculoskeletal (75%), neurologic (60%), pulmonary (100%) systems and for mental health symptoms (38%).
The findings suggest that the risk horizon... is further prolonged among hospitalized individuals—highlighting the importance of reducing risk of hospitalization among people with SARS-CoV-2 infection."
At 2 years, long COVID had cumulatively contributed 80.4 and 642.8 disability-adjusted life years (DALYs) per 1,000 people in nonhospitalized and hospitalized veterans, respectively. Of the cumulative 2-year DALYs, 25.3% and 21.3% in nonhospitalized and hospitalized participants were from year 2.
"While risks of many sequelae declined 2 years after infection, the substantial cumulative burden of health loss due to PASC [postacute sequelae of COVID-19] calls for attention to the care needs of people with long-term health effects due to SARS-CoV-2 infection," the study authors wrote.
"The findings suggest that the risk horizon for postacute sequelae after SARS-CoV-2 infection is prolonged even among nonhospitalized individuals and is further prolonged among hospitalized individuals—highlighting the importance of reducing risk of hospitalization among people with SARS-CoV-2 infection," they added.
Persistent symptoms, new-onset conditions
For the second paper, Robert Koch Institute researchers in Germany conducted a multicenter study on adult COVID-19 patients' health 1 to 1.5 years after their 2020 infections compared with uninfected controls.
Participants in the four regions of the country most affected by COVID-19 in 2020 completed baseline and follow-up questionnaires on recurrent or persistent health problems, new-onset diseases, health-related quality of life, subjective health, and subjective memory impairment from October 2021 to January 2022.
The findings were published yesterday in BMC Public Health.
Of 4,817 participants, 350 (7.3%) had COVID-19 at baseline, and 4,467 were uninfected at baseline or during follow-up. The average age was 49.8 years, slightly more than half were women, 17% were obese, more than a third had an underlying illness, less than 10% were aged 75 or older, and 6 were hospitalized due to COVID-19, but none required intensive care.
Infected participants more often reported 7 of 18 recurrent or persistent symptoms at follow-up, including impaired smell or taste (12.8% vs 3.4%; odds ratio [OR], 4.11), shortness of breath (23.0% vs 9.5%; OR, 3.46), pain with breathing (4.7% vs 1.9%; OR, 2.36), fatigue (36.9% vs 26.1%; OR, 1.76), leg weakness (12.8% vs 7.8%; OR, 1.93), muscle or joint pain (21.9% vs 15.1%; OR, 1.53), and cough (30.8% vs 24.8%; OR, 1.34).
Post-COVID patients also were more likely to report 3 of 6 groups of new-onset diseases, including those of the liver or kidneys (2.7% vs 0.9%; OR, 3.70), lung (3.2% vs 1.1%; OR, 3.50), and cardiovascular or metabolic (6.5% vs 4.0%; OR, 1.68) systems.
The results point to considerable long-term impact of SARS-CoV-2 infection on health and well-being among adults with a mainly mild course of acute infection.
The absence of all 18 studied health problems was less likely among participants with COVID-19 at baseline (45.9%) than among uninfected participants (60.0%). A multivariable ordinal regression analysis revealed a significant link between infection and a higher number of persistent health problems (OR, 1.83).
Compared with uninfected participants, those with COVID-19 had significantly higher odds of reporting poor subjective health (19.3% vs 13.0%; OR, 1.91), memory impairment (25.7% vs 14.3%; OR, 2.27), and worse average fatigue and physical function scores.
The results "point to considerable long-term impact of SARS-CoV-2 infection on health and well-being among adults with a mainly mild course of acute infection," the authors concluded. "Harnessing high-quality population-based epidemiological and health care research on long COVID is necessary to guide the planning and implementation of effective preventive and health care services."
Studies note higher risk of death, impaired health up to 2 years after COVID infection
Mary Van Beusekom, MS
Today at 3:54 p.m.
COVID-19
A pair of new studies describe the risks associated with long COVID, with one showing a significantly elevated risk of death among patients who required hospitalization and another finding an increased risk of health problems, functional limitations, and worse well-being after 1 year.A 'substantial cumulative burden'
Researchers from the Veterans Affairs Saint Louis Health Care System followed 138,818 US veterans (20,580 of them hospitalized and 118,238 not hospitalized) during their COVID-19 infections and 5,985,227 of their uninfected peers for 2 years to estimate their risk of death and 80 long-COVID symptoms.
The study was published yesterday in Nature Medicine.
The average age of the COVID-19 group was 60.9 years, and 11.4% were women. In the control group, the average age was 62.8 years, and 9.9% were women. Median follow-up time was 715 days in the infected group and 719 in the control group.
The increased risk of death was not significant beyond 6 months after infection among nonhospitalized veterans but was significantly elevated through 2 years in those admitted to the hospital. A total of 69% and 35% of the 80 long-COVID signs and symptoms became nonsignificant 2 years after infection in nonhospitalized and hospitalized veterans, respectively.
Among hospitalized veterans, risks at 2 years after infection remained increased for 65% of long-COVID signs and symptoms, including those involving the cardiovascular (57%), coagulation and hematologic (80%), endocrine (100%), gastrointestinal (82%), renal (75%), musculoskeletal (75%), neurologic (60%), pulmonary (100%) systems and for mental health symptoms (38%).
The findings suggest that the risk horizon... is further prolonged among hospitalized individuals—highlighting the importance of reducing risk of hospitalization among people with SARS-CoV-2 infection."
At 2 years, long COVID had cumulatively contributed 80.4 and 642.8 disability-adjusted life years (DALYs) per 1,000 people in nonhospitalized and hospitalized veterans, respectively. Of the cumulative 2-year DALYs, 25.3% and 21.3% in nonhospitalized and hospitalized participants were from year 2.
"While risks of many sequelae declined 2 years after infection, the substantial cumulative burden of health loss due to PASC [postacute sequelae of COVID-19] calls for attention to the care needs of people with long-term health effects due to SARS-CoV-2 infection," the study authors wrote.
"The findings suggest that the risk horizon for postacute sequelae after SARS-CoV-2 infection is prolonged even among nonhospitalized individuals and is further prolonged among hospitalized individuals—highlighting the importance of reducing risk of hospitalization among people with SARS-CoV-2 infection," they added.
Persistent symptoms, new-onset conditions
For the second paper, Robert Koch Institute researchers in Germany conducted a multicenter study on adult COVID-19 patients' health 1 to 1.5 years after their 2020 infections compared with uninfected controls.
Participants in the four regions of the country most affected by COVID-19 in 2020 completed baseline and follow-up questionnaires on recurrent or persistent health problems, new-onset diseases, health-related quality of life, subjective health, and subjective memory impairment from October 2021 to January 2022.
The findings were published yesterday in BMC Public Health.
Of 4,817 participants, 350 (7.3%) had COVID-19 at baseline, and 4,467 were uninfected at baseline or during follow-up. The average age was 49.8 years, slightly more than half were women, 17% were obese, more than a third had an underlying illness, less than 10% were aged 75 or older, and 6 were hospitalized due to COVID-19, but none required intensive care.
Infected participants more often reported 7 of 18 recurrent or persistent symptoms at follow-up, including impaired smell or taste (12.8% vs 3.4%; odds ratio [OR], 4.11), shortness of breath (23.0% vs 9.5%; OR, 3.46), pain with breathing (4.7% vs 1.9%; OR, 2.36), fatigue (36.9% vs 26.1%; OR, 1.76), leg weakness (12.8% vs 7.8%; OR, 1.93), muscle or joint pain (21.9% vs 15.1%; OR, 1.53), and cough (30.8% vs 24.8%; OR, 1.34).
Post-COVID patients also were more likely to report 3 of 6 groups of new-onset diseases, including those of the liver or kidneys (2.7% vs 0.9%; OR, 3.70), lung (3.2% vs 1.1%; OR, 3.50), and cardiovascular or metabolic (6.5% vs 4.0%; OR, 1.68) systems.
The results point to considerable long-term impact of SARS-CoV-2 infection on health and well-being among adults with a mainly mild course of acute infection.
The absence of all 18 studied health problems was less likely among participants with COVID-19 at baseline (45.9%) than among uninfected participants (60.0%). A multivariable ordinal regression analysis revealed a significant link between infection and a higher number of persistent health problems (OR, 1.83).
Compared with uninfected participants, those with COVID-19 had significantly higher odds of reporting poor subjective health (19.3% vs 13.0%; OR, 1.91), memory impairment (25.7% vs 14.3%; OR, 2.27), and worse average fatigue and physical function scores.
The results "point to considerable long-term impact of SARS-CoV-2 infection on health and well-being among adults with a mainly mild course of acute infection," the authors concluded. "Harnessing high-quality population-based epidemiological and health care research on long COVID is necessary to guide the planning and implementation of effective preventive and health care services."