10 December 2022

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COVID-19: two years later, more than half of patients have symptoms

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Nearly three years after SARS-CoV-2 became commonly known, at least one symptom attributable to it remained in 59.7% of patients hospitalized at the time of the acute phase. Researchers also found at least one post-COVID-19 symptom in 67.5% of patients who had not needed hospital care, according to a new study with 700 patients conducted in Spain. 

“Post-COVID-19 symptoms 2 years after SARS-CoV-2 infection among hospitalized vs nonhospitalized patients,” was published in November 2022 in JAMA Network Open.

César Fernández-de-las-Peñas, of the Universidad Rey Juan Carlos in Madrid, Spain, lead author of the paper, said researchers "sought to identify long-term post-COVID-19 symptoms between hospitalized and outpatients.” 

The research team compared the presence of post-COVID-19 symptoms two years after acute infection in these populations, he said. Researchers conducted a cross-sectional study at urban hospitals and general practice centers from March 20 to April 30, 2020, including 360 hospitalized patients and 308 outpatients with acute SARS-CoV-2 infection.

Data on infection and eventual hospitalization were collected from medical records, while follow-up was conducted two years later via a telephone interview.

The experts observed that dyspnea was more prevalent early in the disease among hospitalized than outpatients (112 versus 36), while the reverse was true for anosmia (66 versus 36 patients). The number of individuals who showed at least one post-COVID-19 symptom two years after infection was 215 (59.7%) among hospitalized patients and 208 (67.5%) among outpatients.

Among hospitalized and outpatients, fatigue (161 vs 147), pain (129 vs 92), and memory loss (72 vs 49) were the most prevalent symptoms two years after SARS-CoV-2 infection. Therefore, researchers found no significant differences in post-COVID-19 symptoms were observed between patients in the two groups.

The number of pre-existing comorbidities was associated with post-COVID-19 fatigue and dyspnea among patients who were hospitalized, while the number of comorbidities and number of symptoms at disease onset were related to post-COVID- 19 among outpatients.

The lack of inclusion of noninfected control patients limits the ability to assess the association of SARS-CoV-2 infection with general and specific symptoms post -COVID-19, the authors concluded. For this reason, future studies should include uninfected control populations.

César Fernández-de-Las-Peñas et al. “Post-COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients.” JAMA Netw Open. 2022 Nov 1;5(11): e2242106. doi: 10.1001/jamanetworkopen.2022.42106.