Severe COVID-19 Illness Associated With Long COVID Up to 2 Years Later

Severe physical symptoms after COVID-19, or long COVID, up to 27 months after SARS-CoV-2 infection were most prevalent in people who were bedridden with COVID-19 for 7 days or more, according to study results published online in The Lancet Regional Health – Europe.

“Long COVID has grown into a major public health problem since a large proportion of the global population has been infected,” said researcher Emily Joyce, a doctoral student at the Karolinska Institute in Sweden. “Our results show the long-term health consequences of the pandemic and highlight the importance of monitoring physical symptoms for up to 2 years after diagnosis, especially in people who experienced severe COVID-19.”

The study included 64,880 adults from Iceland, Sweden, Denmark, and Norway. Among them, 22,382 were diagnosed with COVID-19. Researchers looked at the prevalence of more than a dozen self-reported physical symptoms in participants between April 2020 and August 2022.

Compared with participants never diagnosed with COVID-19, those diagnosed with COVID-19 had a 37% higher prevalence of severe physical symptom burden over as many as 27 months of follow-up, according to the study. Symptoms that were significantly elevated included shortness of breath, chest pain, dizziness, heart racing, headaches, low energy/fatigue, trouble sleeping, and back pain.

Among adults with a COVID-19 diagnosis, those bedridden for 7 days or longer during the acute phase had the greatest and most persistent rise in prevalence of severe physical symptoms, the study found. Adults not bedridden during the acute phase of COVID-19 had a similar physical symptom prevalence at follow-up as adults never diagnosed with COVID-19.

“This multinational study of persons with COVID-19 in four Nordic countries indicates that severe acute illness of SARS-CoV-2 infection is an important predictor of persistent physical symptoms, eg, shortness of breath, chest pain, dizziness, headaches, and low energy/fatigue, up to 27 months after diagnosis,” researchers wrote.

References

Shen Q, Joyce EE, Ebrahimi OV, et al. COVID-19 illness severity and 2-year prevalence of physical symptoms: an observational study in Iceland, Sweden, Norway and Denmark. The Lancet Regional Health – Europe. Published online October 26, 2023. doi:10.1016/j.lanepe.2023.100756

Long COVID most prevalent in the most seriously ill. News release. Karolinska Institute; October 27, 2023. Accessed November 14, 2023.