Factors associated with long COVID symptoms in an online cohort study

Authors

Matthew S. Durstenfeld, Division of Cardiology at ZSFG, and Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Michael J. Peluso, Division of HIV, Infectious Disease, Global Medicine, University of California, San Francisco, San Francisco, California, USA.
Noah D. Peyser, Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Feng Lin, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
Sara J. Knight, Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
Audrey Djibo, CVS Health Clinical Trial Services, Blue Bell, Pennsylvania, USA.
Rasha Khatib, Advocate Aurora HealthFollow
Heather Kitzman, Baylor Scott and White Health and Wellness Center, Dallas, Texas, USA.
Emily O'Brien, Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Natasha Williams, Institute for Excellence in Health Equity, Center for Healthful Behavior Change, NYU Grossman School of Medicine, New York, New York, USA.
Carmen Isasi, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
John Kornak, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
Thomas W. Carton, Louisiana Public Health Institute, New Orleans, Louisiana, USA.Follow
Jeffrey E. Olgin, Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Mark J. Pletcher, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.
Gregory M. Marcus, Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
Alexis L. Beatty, Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.Follow

Recommended Citation

Durstenfeld MS, Peluso MJ, Peyser ND, et al. Factors Associated With Long COVID Symptoms in an Online Cohort Study. Open Forum Infect Dis. 2023;10(2):ofad047. Published 2023 Feb 1. doi:10.1093/ofid/ofad047

Abstract

Background: Few prospective studies of Long COVID risk factors have been conducted. The purpose of this study was to determine whether sociodemographic factors, lifestyle, or medical history preceding COVID-19 or characteristics of acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are associated with Long COVID.

Methods: In March 26, 2020, the COVID-19 Citizen Science study, an online cohort study, began enrolling participants with longitudinal assessment of symptoms before, during, and after SARS-CoV-2 infection. Adult participants who reported a positive SARS-CoV-2 test result before April 4, 2022 were surveyed for Long COVID symptoms. The primary outcome was at least 1 prevalent Long COVID symptom greater than 1 month after acute infection. Exposures of interest included age, sex, race/ethnicity, education, employment, socioeconomic status/financial insecurity, self-reported medical history, vaccination status, variant wave, number of acute symptoms, pre-COVID depression, anxiety, alcohol and drug use, sleep, and exercise.

Results: Of 13 305 participants who reported a SARS-CoV-2 positive test, 1480 (11.1%) responded. Respondents' mean age was 53 and 1017 (69%) were female. Four hundred seventy-six (32.2%) participants reported Long COVID symptoms at a median 360 days after infection. In multivariable models, number of acute symptoms (odds ratio [OR], 1.30 per symptom; 95% confidence interval [CI], 1.20-1.40), lower socioeconomic status/financial insecurity (OR, 1.62; 95% CI, 1.02-2.63), preinfection depression (OR, 1.08; 95% CI, 1.01-1.16), and earlier variants (OR = 0.37 for Omicron compared with ancestral strain; 95% CI, 0.15-0.90) were associated with Long COVID symptoms.

Conclusions: Variant wave, severity of acute infection, lower socioeconomic status, and pre-existing depression are associated with Long COVID symptoms.

Document Type

Article

PubMed ID

36846611