Approximately 30% of Patients With COVID-19 Develop Long-Term Disease

Individuals with diabetes, a higher body mass index, or a history of hospitalization are more likely to develop the condition, the analysis shows.

Approximately 30% of individuals treated for COVID-19 developed post-acute sequelae of the known, also known as long COVID, according to the results of a new study from the University of California at Los Angeles.1

Additionally, individuals with diabetes, a higher body mass index, or a history of hospitalization, were most likely to develop the condition.1

Meanwhile, individuals who were by Medicaid instead of commercial health insurance or likely had an organ transplant were less to develop long COVID.1

Those with commercial insurance had double the likelihood of developing long COVID compared to those who had Medicaid, investigators said in a statement.two

Ethnicity, older age, and socioeconomic status were not associated with long COVID, even though those characteristics have been linked with severe illness and a greater risk of death from COVID-19 in previous studies.1

“This study illustrates the need to follow diverse patient populations longitudinally to understand the long COVID disease trajectory and evaluate how individual factors, such as pre-existing co-morbidities, sociodemographic factors, vaccination status, and virus variant type, affect type and persistence of long COVID symptoms,” Sun Yoo, MD, MPh, health sciences assistant clinical professor at David Geffen School of Medicine at UCLA and medical director of the Extensivist Program, said in the statement. “Studying outcomes in a single health system can minimize variation in quality of medical care.”1

Of the 309 individuals with long COVID included in the study, the most common symptoms were fatigue and shortness of breath, at 31% and 15%, respectively, in hospitalized individuals. For outpatients, the most common symptom was loss of sense of smell, up to 16%.1

Investigators at UCLA enrolled 1038 individuals in the UCLA COVID Ambulatory Program between April 2020 and February 2021.1 There were 800 individuals who received treatment for COVID-19 in the hospital, and 238 were treated as high-risk outpatient individuals.1

The patients had an acute COVID-19 illness, according to investigators.

Investigators were also able to control factors, such as access and quality of care, which are often lacking in studies.two

In the study, 309 individuals developed long COVID, which was classified as such if the individual reported persistent symptoms on questionnaires at 60 or 90 days after infection or hospitalization.1

Two hundred forty-six individuals who were hospitalized developed long COVID, and 63 who were treated as outpatients developed long COVID.two

Potential limitations of the study included limited information about patients’ pre-existing conditions and a limited number of symptoms evaluated, investigators said.1

“Because persistent symptoms can be subjective in nature, we need better tools to accurately diagnose long COVID and to differentiate it from exacerbations of other emerging or chronic conditions. Finally, we need to ensure equitable access to outpatient long COVID care,” Yoo said.1

Reference

1. About 30% of COVID patients develop “long COVID,” UCLA research finds. EurekAlert. News release. April 18, 2022. Accessed April 20, 2022. https://www.eurekalert.org/news-releases/950046

2. Yoo SM, Liu TC, Motwani Y, Sim MS, et al. Factors associated with post-acute sequelae of SARS-CoV-2 (PASC) after diagnosis of symptomatic COVID-19 in the inpatient and outpatient setting in a diverse cohort. J General Intern Med. 2022. doi:10.1007/s11606-022-07523-3

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