Long COVID in a prospective cohort of home-isolated patients - PubMed (original) (raw)

. 2021 Sep;27(9):1607-1613.

doi: 10.1038/s41591-021-01433-3. Epub 2021 Jun 23.

Bjørn Blomberg 1 2 3, Karl Albert Brokstad 6 7, Fan Zhou 5, Dagrun Waag Linchausen 8, Bent-Are Hansen 9, Sarah Lartey 5, Therese Bredholt Onyango 5, Kanika Kuwelker 10 11 4 5, Marianne Sævik 4, Hauke Bartsch 12 13, Camilla Tøndel 14 15, Bård Reiakvam Kittang 10 9; Bergen COVID-19 Research Group; Rebecca Jane Cox # 16 17, Nina Langeland # 18 19 20

Collaborators, Affiliations

Long COVID in a prospective cohort of home-isolated patients

Bjørn Blomberg et al. Nat Med. 2021 Sep.

Abstract

Long-term complications after coronavirus disease 2019 (COVID-19) are common in hospitalized patients, but the spectrum of symptoms in milder cases needs further investigation. We conducted a long-term follow-up in a prospective cohort study of 312 patients-247 home-isolated and 65 hospitalized-comprising 82% of total cases in Bergen during the first pandemic wave in Norway. At 6 months, 61% (189/312) of all patients had persistent symptoms, which were independently associated with severity of initial illness, increased convalescent antibody titers and pre-existing chronic lung disease. We found that 52% (32/61) of home-isolated young adults, aged 16-30 years, had symptoms at 6 months, including loss of taste and/or smell (28%, 17/61), fatigue (21%, 13/61), dyspnea (13%, 8/61), impaired concentration (13%, 8/61) and memory problems (11%, 7/61). Our findings that young, home-isolated adults with mild COVID-19 are at risk of long-lasting dyspnea and cognitive symptoms highlight the importance of infection control measures, such as vaccination.

© 2021. The Author(s).

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1

Fig. 1. Study population flow chart.

Number of participants eligible for inclusion at baseline, blood sampling at 2 months and assessment and fatigue evaluation at 6 months. BMEC, Bergen Municipality Emergency Clinic; LTF, lost to follow-up.

Fig. 2

Fig. 2. Six-month follow-up of patients with COVID-19 in Bergen, Norway.

The relationship of severity of initial COVID-19 illness and of age with anti-SARS-CoV-2 spike (a and b) and microneutralizing antibody titers (e and f) at 2 months. The relationship of antibody titers at 2 months with number of persistent symptoms (c and g) and total fatigue score according to the Chalder scale (d and h) at 6-month follow-up. The 13 symptoms used are listed in Table 2. The severity of illness was as follows: 1—asymptomatic (n = 5); 2—home-isolated with symptoms (n = 242); 3—hospitalized without medical needs (n = 0); 4—hospitalized with medical needs (n = 31); 5—hospitalized needing O2 (n = 24); 6—hospitalized needing non-invasive ventilation (n = 4); and 7—hospitalized needing respirator (n = 6). The cohort was divided into 15-year age groups: 0–15 (n = 16), 16–30 (n = 65), 31–45 (n = 69), 46–60 (n = 90) and >60 (n = 72). a, b, e and f show median spike IgG and microneutralizing antibody titers (horizontal line), 25% and 75% quantiles (box), plus 95% confidence intervals (lines) with outliers (dots). c and d are violin plots of number of symptoms (up to 13) or fatigue score (values 0–33) divided into four categories of spike IgG: <150 (_n_ = 21), 150–4999 (_n_ = 96), 5,000–20,000 (_n_ = 103) and >20,000 (n = 92). 5k, 5,000; 20k, 20,000. g and h are violin plots of four categories of microneutralizing titers: <20 (neg _n_ = 42), 20–79 (_n_ = 107), 80–320 (_n_ = 92) and >320 (n = 71). O2, supplemental oxygen.

Extended Data Fig. 1

Extended Data Fig. 1. Correlations between severity of acute illness, antibody titres at 2 months and number of symptoms at 6 months follow-up.

Panel a is a scatter plot showing the correlation between severity of initial illness and the Spike IgG antibody titres (log 10) at 2 months follow-up. Panel b shows the correlation between Spike IgG antibody titres (log 10) at 2 months follow-up and the number of symptoms at 6 months follow-up, stratified by severity of initial illness, that is home-isolated versus hospitalised patients. A regression line calculated by linear model is shown in each graph with standard error represented by the shaded area.

Similar articles

Cited by

References

    1. Gupta A, et al. Extrapulmonary manifestations of COVID-19. Nat. Med. 2020;26:1017–1032. doi: 10.1038/s41591-020-0968-3. - DOI - PubMed
    1. Meeting the challenge of long COVID. Nat. Med.26, 1803 (2020). - PubMed
    1. Zhou F, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed
    1. Menni C, et al. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat. Med. 2020;26:1037–1040. doi: 10.1038/s41591-020-0916-2. - DOI - PMC - PubMed
    1. von Weyhern CH, Kaufmann I, Neff F, Kremer M. Early evidence of pronounced brain involvement in fatal COVID-19 outcomes. Lancet. 2020;395:e109. doi: 10.1016/S0140-6736(20)31282-4. - DOI - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources