Attributes and predictors of long COVID

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.

Automated summary

Reports on long-lasting COVID-19 symptoms, known as 'long COVID', are increasing. Analysis of data from over 4,000 COVID-19 cases revealed that long COVID is more common in older individuals, those with higher body mass index, and females. Experiencing more than five symptoms in the first week of illness was associated with long COVID. A simple model showed promise in distinguishing between short and long COVID cases early in the disease.