Post-COVID Syndrome: Persistence of Symptoms and Risk Factors (Longitudinal Observational Study)

The aim - studying the dynamics of symptoms of post-COVID syndrome (depending on the results of depending on the results of the polymerase chain reaction for SARS-CoV-2) and the factors influencing it.
Materials and methods. A study is a cohort, observational longitudinal. Stage I: snapshot analysis of medical records of patients with COVID-19 disease history 12 months. (questionnaire for post-COVID syndrome, blood tests). Stage II: questionnaire repeat, disease history — 24 months. There were test (positive polymerase chain reaction, 138 people) and control (negative polymerase chain reaction, 87 people) groups. Statistical analysis: package Statistica 13.5.0.17.
Results. 1 year after COVID-19, the frequency of manifestations of post-COVID syndrome was (test vs control group): asthenia 63 % vs 64 %, decreased quality of life 59 % vs 56 %, respiratory syndrome 60 % vs 49 %, arthralgia 55 % vs 49 %, cardiac syndrome 47 % vs 46 % (the difference is not significant); symptoms are associated with female gender (r=0.231- 0.379), severity of COVID-19 (r=0.187-0.425), D-dimer (r=0.244-0.328). After 2 years, the frequency of symptoms was: asthenia 43 % vs 45 %, cardiac symptoms 23 % vs 15 %, respiratory symptoms 18 % vs 22 %, skin manifestations 8 % vs 12 %, decreased quality of life 7 % vs 9 %, the difference is not significant; symptoms are associated with age (r=0.208-0.402). During two years, symptoms have been correlating with platelets (r=-0.322-0.403), liver enzymes (r=0.216-0.298), blood lipids (r=0.188-0.257).
Conclusions. The severity of post-COVID syndrome does not depend on the results of the polymerase chain reaction for SARS-CoV-2. The frequency of cardiac and respiratory syndromes after 2 years decreases by 2-3 times; quality of life improves. Asthenia is the most long-term syndrome. Risk factors for post-COVID syndrome during the 1st year — severity of COVID-19, female gender, D-dimer level; from the 2nd year — age. For two years after COVID-19, monitoring of liver enzymes, lipids, and platelets is required.

1. NICE guideline [NG188]. COVID-19 rapid guideline: managing the long-term effects of COVID-19; Published: 18 December 2020 Last updated: 25 January 2024. [Electronic resource]. URL: https://www.nice.org.uk/guidance/ng188 (date of the application: 26.01.2024)

2. Varisco B. , Bai F., Benedittis S. EuCARE-POSTCOVID Study: a multicentre cohort study on long-term post-COVID-19 manifestations. BMC Infect Dis. 2023; 23(1): 684. doi: 10.1186/s12879-023-08595-0

3. Nalbandian A., Desai A., Wan E. et al. Post-COVID-19 Condition. Annu Rev Med. 2023; 74: 55-64. doi: 10.1146/annurev-med-043021-030635

4. Hanson S.W., Abbafati C., Aerts J.G. Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021 JAMA. 2022; 328(16): 1604-1615. doi: 10.1001/jama.2022.18931

5. Amirov N.B., Davletshina E.I., Vasil’yeva A.G et al. Post-COVID syndrome: multisystem “deficiencies”. Vestnik Sovremennoi Klinicheskoi Mediciny. 2021; 14(6): 94-104. doi: 10.20969/VSKM.2021.14(6). 94-104 [In Russian]

6. Tajer C., Martínez M.J., Mariani J. et al. Post COVID-19 syndrome. Severity and evolution in 4673 health care workers. Medicina (B Aires). 2023; 83(5): 669-682. PMID: 37870325

7. Staffolani S., Iencinella V. , Cimatti M. et al. Long COVID-19 syndrome as a fourth phase of SARS-CoV-2 infection. Infez Med. 2022; 30(1): 22-29. doi: 10.53854/liim-3001-3

8. Shin J.Y. Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infectious diseases. 2021; 53(10): 737-754. doi: 10.1080/23744235.2021.1924397.

9. Morioka S., Tsuzuki S., T Maruki et al. Epidemiology of post-COVID conditions beyond 1 year: a cross-sectional study. Public Health. 2023; 216:39-44. doi: 10.1016/j.puhe.2023.01.008

10. Tamasi J., Kalabay L. Monitoring the development of post-COVID–19 syndrome. Orvosi hetilap. 2022; 163(9): 335-342. doi: 10.1556/650.2022.32432

11. Gulyaev P.V., Resnyanskaya S.V., Starovskaya I.V. Identification of postcovid syndrome in patients who have undergone a new coronavirus infection. Modern problems of public health and medical statistics. 2022; (2): 107. doi: 10.24412/2312-2935-2022-2-107-128 [In Russian]

12. Lippi G., Mullier F., Favaloro E.J. D-dimer: old dogmas, new (COVID-19) tricks. Clinical chemistry and laboratory medicine. 2022;14; 61(5): 841-850. doi: 10.1515/cclm-2022-0633

13. Nikolaev N.A., Drapkina O.M., Livzan M.A. The MARKIZ study: screening for post-COVID syndrome using a questionnaire to identify symptoms and risk factors for non-communicable diseases. Cardiovascular therapy and prevention. 2022; 21(12): 190-200. doi: 10.15829/1728-8800-2022-3484 [In Russian]

14. Antar A.A. R , Tong Yu., Demko Z. O et al. Long COVID brain fog and muscle pain are associated with longer time to clearance of SARS-CoV-2 RNA from the upper respiratory tract during acute infection. Front Immunol. 2023; 14: 1147549. doi: 10.3389/fimmu.2023.1147549

15. Pink I., Welte T. Frequency, spectrum and risk factors of long COVID. Inn Med (Heidelb). 2022; 63(8): 813-818. doi: 10.1007/s00108-022-01370-4