Risk factors of post Covid-19 Syndrome


What you need to know?



Many people recover quickly from COVID-19. But for some, symptoms can continue months after recovery and may involve multiple organs. This is known as Long COVID, or post-acute sequelae of SARS-CoV-2 (PASC). SARS-CoV-2 is the virus that causes COVID-19.
In a study supported by the National Institute of Allergy and Infectious Diseases (NIAID), the National Center for Advancing Translational Sciences, and the National Institute on Drug Abuse, researchers studied samples from COVID-19 patients over time, which led to many insights, including some of the risk factors for Long COVID.

What did the researchers do?




The researchers enrolled 209 people ages 18 to 89 who had laboratory-confirmed SARS-CoV-2 infections. The participants’ COVID-19 experiences ranged from having mild symptoms and never having to be hospitalized to needing mechanical ventilation in the intensive care unit.
With the participants’ consent, researchers studied their electronic health records, interviewed them about their symptoms, and took blood samples. All participants were asked to come back 60 and 90 days after their initial COVID-19 symptoms started.
The researchers compared the 209 patients with people who had not had COVID-19 and checked their findings against a separate group of 100 people who had COVID-19 and were 60 to 90 days beyond developing their initial symptoms.

What did the researchers find?




Three months after being diagnosed with COVID-19, half of the 209 participants reported fatigue. A quarter of them had a cough, and 18% had loss of smell or taste.
The researchers found that people were more likely to have symptoms 2 to 3 months after diagnosis if they had any of several risk factors at the time they were diagnosed, including:
Type 2 diabetes



Reactivated: Many people are infected with this virus in childhood. After infection, the virus persists in the body in an inactive form but may reactivate.
Autoantibodies: While antibodies should bind only to materials from outside the body, some people make antibodies against their own tissues. The researchers checked for a few different autoantibodies.
The researchers also made other observations. For example, people who had cold-like symptoms at 3 months also had low levels of the hormone cortisol.
These risk factors are only part of the picture, the researchers noted — a person's genetics likely also play a factor in their Long COVID risk.

Why is this research important?




This study takes a broad look at the biology of Long COVID and picks out some factors that are shared across many people.
As more research is done to understand Long COVID, scientists can use this information to develop new hypotheses on how it affects people's health. Then they can design new studies on the causes, prevention, and treatment of Long COVID. These studies will lead to treatments for people with long-term symptoms.

Post- COVID syndrome and associated factors


The PCS was detected in 141 patients (50.9%; 95%CI 45.0–56.7). The cumulative incidence was 58.2% (95%CI 51.0–65.2), 36.6% (95%CI 23.5–51.8) and 37.0% (95%CI 25.4–50.3) in patients with severe pneumonia, mild pneumonia and without pneumonia, respectively (p = 0.003).
The most frequent symptoms were dyspnea and fatigue. Anosmia-dysgeusia was associated with younger age (<65 yr 24.9% (48/194) vs >65 yr 13.5% (11/83), p 0.03). The most relevant laboratory findings were lymphopenia and high ferritin and D-dimer levels.
Relevant neurological symptoms (headache, memory disorders / cognitive deterioration, or both) were present in 33 patients (11.9%).
The neurological and respiratory symptoms generally improved in the evaluation by specialists, 16–18 weeks after disease onset, with persistent alterations that required medical follow-up by pneumologits in 13.3% (37/277) and neurologist in 7.5% (21/277).
In severe pneumonia, only opacities of lung surface on X-rays >50% (OR 2.87 (1.13–7.32), p = 0.027) and higher heart rate at admission (OR 1.03 (1.01–1.06, p = 0.04), were independent predictors of post-COVID syndrome.
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Made by Aditi Dwivedi

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