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Epidemiology, Symptomatology, and Risk Factors for Long COVID Symptoms: Population-Based, Multicenter Study.
Wong, Martin Chi-Sang; Huang, Junjie; Wong, Yuet-Yan; Wong, Grace Lai-Hung; Yip, Terry Cheuk-Fung; Chan, Rachel Ngan-Yin; Chau, Steven Wai-Ho; Ng, Siew-Chien; Wing, Yun-Kwok; Chan, Francis Ka-Leung.
  • Wong MC; Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong, Sha Tin, China.
  • Huang J; Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, China.
  • Wong YY; School of Public Health, Peking University, Beijing, China.
  • Wong GL; School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
  • Yip TC; Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong, Sha Tin, China.
  • Chan RN; Centre for Health Education and Health Promotion, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, China.
  • Chau SW; Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong, Sha Tin, China.
  • Ng SC; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, China.
  • Wing YK; Medical Data Analytics Centre, The Chinese University of Hong Kong, Sha Tin, China.
  • Chan FK; Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, China.
JMIR Public Health Surveill ; 9: e42315, 2023 03 07.
Article in English | MEDLINE | ID: covidwho-2286920
ABSTRACT

BACKGROUND:

Long COVID induces a substantial global burden of disease. The pathogenesis, complications, and epidemiological and clinical characteristics of patients with COVID-19 in the acute phase have been evaluated, while few studies have characterized the epidemiology, symptomatology, and risk factors of long COVID symptoms. Its characteristics among patients with COVID-19 in the general population remain unaddressed.

OBJECTIVE:

We examined the prevalence of long COVID symptoms, its symptom patterns, and its risk factors in 4 major Chinese cities in order to fill the knowledge gap.

METHODS:

We performed a population-based, multicenter survey using a representative sampling strategy via the Qualtrics platform in Beijing, Shanghai, Guangzhou, and Hong Kong in June 2022. We included 2712 community-dwelling patients with COVID-19 and measured the prevalence of long COVID symptoms defined by the World Health Organization (WHO), and their risk factors. The primary outcomes were the symptoms of long COVID, with various levels of impact. A descriptive analysis of the prevalence and distribution of long COVID symptoms according to disease severity was conducted. A sensitivity analysis of increasing the number of long COVID symptoms was also conducted. Univariate and multivariate regression analyses were performed to examine the risk factors of severe long COVID symptoms, including age, gender, marital status, current occupation, educational level, living status, smoking habits, monthly household income, self-perceived health status, the presence of chronic diseases, the use of chronic medication, COVID-19 vaccination status, and the severity of COVID-19.

RESULTS:

The response rate was 63.6% (n=2712). The prevalence of long COVID, moderate or severe long COVID, and severe long COVID was 90.4% (n=2452), 62.4% (n=1692), and 31.0% (n=841), respectively. Fatigue (n=914, 33.7%), cough (n=865, 31.9%), sore throat (n=841, 31.0%), difficulty in concentrating (n=828, 30.5%), feeling of anxiety (n=817, 30.2%), myalgia (n=811, 29.9%), and arthralgia (n=811, 29.9%) were the most common severe long COVID symptoms. From multivariate regression analysis, female gender (adjusted odds ratio [aOR]=1.49, 95% CI 1.13-1.95); engagement in transportation, logistics, or the discipline workforce (aOR=2.52, 95% CI 1.58-4.03); living with domestic workers (aOR=2.37, 95% CI 1.39-4.03); smoking (aOR=1.55, 95% CI 1.17-2.05); poor or very poor self-perceived health status (aOR=15.4, 95% CI 7.88-30.00); ≥3 chronic diseases (aOR=2.71, 95% CI 1.54-4.79); chronic medication use (aOR=4.38, 95% CI 1.66-11.53); and critical severity of COVID-19 (aOR=1.52, 95% CI 1.07-2.15) were associated with severe long COVID. Prior vaccination with ≥2 doses of COVID-19 vaccines was a protective factor (aOR=0.35-0.22, 95% CI 0.08-0.90).

CONCLUSIONS:

We examined the prevalence of long COVID symptoms in 4 Chinese cities according to the severity of COVID-19. We also evaluated the pattern of long COVID symptoms and their risk factors. These findings may inform early identification of patients with COVID-19 at risk of long COVID and planning of rehabilitative services.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Female / Humans Country/Region as subject: Asia Language: English Journal: JMIR Public Health Surveill Year: 2023 Document Type: Article Affiliation country: 42315

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Female / Humans Country/Region as subject: Asia Language: English Journal: JMIR Public Health Surveill Year: 2023 Document Type: Article Affiliation country: 42315