Approximately 80% of hospitalized patients with COVID-19 report persistent symptoms several months after infection onset.1,2 However, knowledge of long-term outcomes among individuals with mild COVID-19 is scarce, and prevalence data are hampered by selection bias and suboptimal control groups.3,4 This cohort study investigated COVID-19–related long-term symptoms in health care professionals.
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Results
Participant enrollment was closed after 2149 of 4375 health care professionals (49%) enrolled; 393 were seropositive. Fifty seropositive participants with severe symptoms and 404 seronegative participants who seroconverted were excluded. Twenty seropositive and 280 seronegative participants did not complete the 8-month follow-up, leaving 323 (94%) seropositive and 1072 (84%) seronegative participants. Seropositive participants who reported no or mild prior symptoms had a median (interquartile range) age of 43 (33-52) years and 268 (83%) were women; continuously seronegative participants had a median (interquartile range) age of 47 (36-56) years and 925 (86%) were women. Underlying chronic disease was reported by 71 (22%) seropositive participants vs 254 (24%) seronegative participants.
Comparing seropositive vs seronegative participants, 26% vs 9% reported at least 1 moderate to severe symptom lasting for at least 2 months (RR, 2.9 [95% CI, 2.2-3.8]) and 15% vs 3% reported at least 1 moderate to severe symptom lasting for at least 8 months (RR, 4.4 [95% CI, 2.9-6.7]) (Table). The most common moderate to severe symptoms lasting for at least 2 months in the seropositive group were anosmia, fatigue, ageusia, and dyspnea.
Of the seropositive participants, 8% reported that their long-term symptoms moderately to markedly disrupted their work life, compared with 4% of the seronegative participants (RR, 1.8 [95% CI, 1.2-2.9]); 15% reported their long-term symptoms moderately to markedly disrupted their social life, compared with 6% of the seronegative participants (RR, 2.5 [95% CI, 1.8-3.6]); and 12% reported that their long-term symptoms moderately to markedly disrupted their home life, compared with 5% of the seronegative participants (RR, 2.3 [95% CI, 1.6-3.4]) (Figure). Furthermore, 11% of the seropositive participants reported moderate to marked disruption in any Sheehan Disability Scale category as well as having at least 1 moderate to severe symptom lasting for at least 8 months, compared with 2% of the seronegative participants (RR, 4.5 [95% CI, 2.7-7.3]).