New research from UCLA finds that 30% of people treated for COVID-19 developed post-acute COVID-19 sequelae (PASC), more commonly known as “long COVID.”
People with a history of hospitalization, diabetes, and a higher body mass index were more likely to develop the condition, while those who had Medicaid coverage, as opposed to commercial health insurance, or who had undergone a transplant organs were less likely to develop it.
Surprisingly, ethnicity, older age, and socioeconomic status were not associated with the syndrome, although those characteristics have been linked to severe illness and an increased risk of death from COVID-19.
Of the 309 people with long COVID studied, the most persistent symptoms were fatigue and shortness of breath (31% and 15%, respectively) in hospitalized people, and loss of sense of smell (16%) in outpatients.
Background
The incidence and risk factors of Long COVID, and even how to define the syndrome, have remained unclear during the pandemic. The researchers sought to evaluate its association with demographics and clinical characteristics to design the most effective treatments.
Methods
UCLA researchers studied 1,038 people who enrolled in the UCLA Outpatient COVID Program between April 2020 and February 2021. Of those, 309 developed long COVID. A person was determined to have the syndrome if they reported persistent symptoms on questionnaires 60 or 90 days after infection or hospitalization.
Potential weaknesses in the study include the subjective nature of how patients rated their symptoms, the limited number of symptoms the researchers assessed, and the limited information about patients’ preexisting conditions.
Impact
“This study illustrates the need to longitudinally follow diverse patient populations to understand the trajectory of Long COVID disease and evaluate how individual factors, such as pre-existing comorbidities, sociodemographic factors, vaccination status, and variant type of the viruses, affect the type and persistence of Long COVID symptoms. ”said Dr. Sun Yoo, clinical assistant professor of health sciences at the David Geffen School of Medicine at UCLA and medical director of the Extensivist Program.
“Studying outcomes in a single health system can minimize variation in the quality of health care. Our study also raises questions such as: Why were patients with commercial insurance twice as likely to develop long COVID as patients insured through Medicaid?
Because persistent symptoms can be subjective in nature, we need better tools to accurately diagnose long COVID and differentiate it from exacerbations of other emergent or chronic conditions. Finally, we must ensure equitable access to Long COVID outpatient care.”
Conclusions Three in ten survivors with COVID-19 developed a subset of symptoms associated with post-acute sequelae of COVID-19 (PASC) in our cohort. Although ethnic minorities, older age, and social disadvantage are associated with worse acute COVID-19 infection and higher risk of death, our study found no association between these factors and PASC. |
