Attributes and predictors of long COVID
Open accessPublished version of a preprint
Abstract
Reports of long-lasting coronavirus disease 2019 (COVID-19) symptoms, the so-called 'long COVID', are rising but little is known about prevalence, risk factors or whether it is possible to predict a protracted course early in the disease. We analyzed data from 4,182 incident cases of COVID-19 in which individuals self-reported their symptoms prospectively in the COVID Symptom Study app 1. A total of 558 (13.3%) participants reported symptoms lasting ≥28 days, 189 (4.5%) for ≥8 weeks and 95 (2.3%) for ≥12 weeks. Long COVID was characterized by symptoms of fatigue, headache, dyspnea and anosmia and was more likely with increasing age and body mass index and female sex. Experiencing more than five symptoms during the first week of illness was associated with long COVID (odds ratio = 3.53 (2.76-4.50)). A simple model to distinguish between short COVID and long COVID at 7 days (total sample size, n = 2,149) showed an area under the curve of the receiver operating characteristic curve of 76%, with replication in an independent sample of 2,472 individuals who were positive for severe acute respiratory syndrome coronavirus 2. This model could be used to identify individuals at risk of long COVID for trials of prevention or treatment and to plan education and rehabilitation services.
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Post-covid syndrome is characterized by several symptoms affecting quality of life.
“This is typically referred to as a post-covid syndrome, characterized by several symptoms affecting quality of life (1–5).”
From Cognitive Behavioral Therapy and Acceptance and Commitment Therapy (CBT-ACT) vs. Standard Care After Critical Illness Due to COVID-19: Protocol for a Pilot Randomized Controlled Trial (2022) · cites this paper as [5]
The Abstract characterizes long COVID by several symptoms, including fatigue, headache, dyspnea and anosmia; the Results describe additional symptoms. The paper does not report a quality-of-life assessment or establish the claimed effect on quality of life (searched for quality of life and daily functioning). Page numbers were not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAmong reported risk factors of developing long COVID, such as older age, female sex, and underlying comorbidities, the severity of the acute infection is substantial.
“Among the reported risk factors of developing long COVID, such as older age, female sex, and underlying comorbidities [3,4], the severity of the acute infection is substantial [31,32].”
From Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis (2023) · cites this paper as [4]
Risk factors for long COVID include older age, female sex, more than five symptoms during acute infection, comorbidities including autoantibodies, and previous psychiatric disorders.
“Some risk factors for long COVID are older age, female sex, having more than five symptoms during the acute stage of the infection, comorbidities including the presence of autoantibodies, and previous psychiatric disorders.”
From The Lancet Commission on lessons for the future from the COVID-19 pandemic (2022) · cites this paper as [351]
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- Authors
- Sudre, C. H., Murray, B., Varsavsky, T., Graham, M. S., Penfold, R. S., Bowyer, R. C., Pujol, J. C., Klaser, K., Antonelli, M., Canas, L. S., Molteni, E., Modat, M., Jorge Cardoso, M., May, A., Ganesh, S., Davies, R., Nguyen, L. H., Drew, D. A., Astley, C. M., Joshi, A. D., Merino, J., Tsereteli, N., Fall, T., Gomez, M. F., Duncan, E. L., Menni, C., Williams, F. M. K., Franks, P. W., Chan, A. T., Wolf, J., Ourselin, S., Spector, T., & Steves, C. J.
- Affiliations
- King's College London (GB)
- ZOE (United Kingdom) (GB)
- Massachusetts General Hospital (US)
- Boston Children's Hospital (US)
- Broad Institute (US)
- Lund University (SE)
- Uppsala University (SE)
- Corresponding author
- Steves, Claire J.
- ORCID
- Sudre, Carole H.
- Murray, Benjamin
- Varsavsky, Thomas
- Graham, Mark S.
- Penfold, Rose S.
- Bowyer, Ruth C.
- Pujol, Joan Capdevila
- Antonelli, Michela
- Canas, Liane S.
- Molteni, Erika
- Jorge Cardoso, M.
- Ganesh, Sajaysurya
- Davies, Richard
- Nguyen, Long H.
- Drew, David A.
- Astley, Christina M.
- Joshi, Amit D.
- Merino, Jordi
- Fall, Tove
- Gomez, Maria F.
- Duncan, Emma L.
- Menni, Cristina
- Williams, Frances M. K.
- Franks, Paul W.
- Chan, Andrew T.
- Wolf, Jonathan
- Ourselin, Sebastien
- Spector, Tim
- Steves, Claire J.
- Venue
- Nature Medicine
- Published
- 2021-03-10
- Volume
- 27
- Issue
- 4
- Pages
- 626-631
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- PMC
- PMC7611399
- OpenAlex
- W3135108774
- Cited by
- 2,707
- References
- 3
- Citations by year
- 2026: 151 · 2025: 289 · 2024: 423 · 2023: 614 · 2022: 748 · 2021: 468 · 2020: 11 · 2018: 1 · 2015: 1
- FWCI
- 269.48
- Type
- journal article
- Language
- en
- Update notices
- correction (2021-05-27)
- Open access
- bronze
- doi.org
- Licence
- Locations
- Nature Medicine (publishedVersion)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- HAL (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- IRIS eCampus Telematic University (Università degli Studi eCampus) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- DH | National Institute for Health Research
- RCUK | Medical Research Council
- Alzheimer’s Society (AS-JF-17-011)
- Wellcome Trust
- Chronic Disease Research Foundation
- Massachusetts Consortium on Pathogen Readiness (MassCPR) and Mark and Lisa Schwartz
- European Commission
- Vetenskapsrådet
- Stiftelsen för Strategisk Forskning
- Hjärt-Lungfonden
- Stuart and Suzanne Steele MGH Research Scholar Award
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- long COVID, risk factors, symptom duration, fatigue, headache, dyspnea, anosmia, body mass index, sex differences, age, prediction model, SARS-CoV-2
- MeSH terms
- COVID-19, SARS-CoV-2, Adult, Age Factors, Aged, Female, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Time Factors
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