Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19

• Published in: PLoS medicine Vol. 18; no. 9; p. e1003773
• Main Authors: Taquet, Maxime, Dercon, Quentin, Luciano, Sierra, Geddes, John R., Husain, Masud, Harrison, Paul J.
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 28.09.2021; Public Library of Science (PLoS)
• Subjects: Abdomen; Age; Anxieties; Anxiety; Atopic dermatitis; Cardiovascular disease; Chest; Codes; Cognitive ability; Cohort analysis; Computer and Information Sciences; Coronaviruses; COVID-19; Dementia; Demography; Electronic health records; Electronic medical records; Ethnicity; Fatigue; Headache; Headaches; Illnesses; Influenza; Long COVID; Medicine and Health Sciences; Mental depression; Myalgia; Pain; Patients; Risk factors; United Kingdom; United States > US
• ISSN: 1549-1676; 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1003773

Long-COVID refers to a variety of symptoms affecting different organs reported by people following Coronavirus Disease 2019 (COVID-19) infection. To date, there have been no robust estimates of the incidence and co-occurrence of long-COVID features, their relationship to age, sex, or severity of infection, and the extent to which they are specific to COVID-19. The aim of this study is to address these issues. We conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors. The incidence and co-occurrence within 6 months and in the 3 to 6 months after COVID-19 diagnosis were calculated for 9 core features of long-COVID (breathing difficulties/breathlessness, fatigue/malaise, chest/throat pain, headache, abdominal symptoms, myalgia, other pain, cognitive symptoms, and anxiety/depression). Their co-occurrence network was also analyzed. Comparison with a propensity score-matched cohort of patients diagnosed with influenza during the same time period was achieved using Kaplan-Meier analysis and the Cox proportional hazard model. The incidence of atopic dermatitis was used as a negative control. Long-COVID clinical features occurred and co-occurred frequently and showed some specificity to COVID-19, though they were also observed after influenza. Different long-COVID clinical profiles were observed based on demographics and illness severity.