ABSTRACT
Estimates of the prevalence of long COVID vary widely. This retrospective cohort study describes the incidence of long COVID symptoms 12-20 weeks post-diagnosis in a US ambulatory care setting and identifies potential risk factors. We identified patients with and without a diagnosis of or positive test for COVID-19 between 1/1/2020 and 3/13/2022 in the Veradigm EHR database. We captured patient demographics, clinical characteristics, and COVID-19 comorbidities in the 12-month baseline period. We compared long COVID symptoms between matched cases and controls 12-20 weeks post-index (COVID-19 diagnosis date [cases] or median visit date [controls]). Multivariable logistic regression was used to examine associations between baseline COVID-19 comorbidities and long COVID symptoms. Among 916,894 patients with COVID-19, 14.8% had at least one long COVID symptom in the 12-20 weeks post-index compared to 2.9% of patients without documented COVID-19. Commonly reported symptoms were joint stiffness (4.5%), cough (3.0%), and fatigue (2.7%). Among patients with COVID-19, the adjusted odds of long COVID symptoms were significantly higher among patients with a baseline COVID-19 comorbidity (odds ratio: 1.91 [95% confidence interval: 1.88-1.95]). In particular, prior diagnosis of cognitive disorders, transient ischemic attack, hypertension, and obesity were associated with higher odds of long COVID symptoms.