This study investigated long COVID, a condition with persistent symptoms lasting beyond 12 weeks after a SARS-CoV-2 infection. Using a UK primary care database, researchers compared 486,149 adults with confirmed infections to nearly 2 million adults without infections. They identified 62 symptoms significantly linked to long COVID, such as loss of smell, hair loss, sneezing, ejaculation difficulties, and reduced libido. Factors increasing the risk of long COVID included being female, from an ethnic minority, socioeconomically deprived, a smoker, obese, or having other health conditions. Younger age also increased the risk. The study highlights the wide range of symptoms and risk factors associated with long COVID.

Abstract

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with a range of persistent symptoms impacting everyday functioning, known as post-COVID-19 condition or long COVID. We undertook a retrospective matched cohort study using a UK-based primary care database, Clinical Practice Research Datalink Aurum, to determine symptoms that are associated with confirmed SARS-CoV-2 infection beyond 12 weeks in non-hospitalized adults and the risk factors associated with developing persistent symptoms. We selected 486,149 adults with confirmed SARS-CoV-2 infection and 1,944,580 propensity score-matched adults with no recorded evidence of SARS-CoV-2 infection. Outcomes included 115 individual symptoms, as well as long COVID, defined as a composite outcome of 33 symptoms by the World Health Organization clinical case definition. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the outcomes. A total of 62 symptoms were significantly associated with SARS-CoV-2 infection after 12 weeks. The largest aHRs were for anosmia (aHR 6.49, 95% CI 5.02–8.39), hair loss (3.99, 3.63–4.39), sneezing (2.77, 1.40–5.50), ejaculation difficulty (2.63, 1.61–4.28) and reduced libido (2.36, 1.61–3.47). Among the cohort of patients infected with SARS-CoV-2, risk factors for long COVID included female sex, belonging to an ethnic minority, socioeconomic deprivation, smoking, obesity and a wide range of comorbidities. The risk of developing long COVID was also found to be increased along a gradient of decreasing age. SARS-CoV-2 infection is associated with a plethora of symptoms that are associated with a range of sociodemographic and clinical risk factors.

Authors: Anuradhaa Subramanian , Krishnarajah Nirantharakumar , Sarah Hughes , Puja Myles , Tim Williams , Krishna M Gokhale , Tom Taverner , Joht Singh Chandan , Kirsty Brown , Nikita Simms-Williams , Anoop D Shah, Megha Singh , Farah Kidy , Kelvin Okoth, Richard Hotham , Nasir Bashir, Neil Cockburn , Siang Ing Lee , Grace M Turner, Georgios V Gkoutos , Olalekan Lee Aiyegbusi, Christel McMullan , Alastair K Denniston , Elizabeth Sapey, Janet M Lord , David C Wraith, Edward Leggett , Clare Iles , Tom Marshall , Malcolm J Price , Steven Marwaha , Elin Haf Davies , Louise J Jackson , Karen L Matthews , Jenny Camaradou , Melanie Calvert , Shamil Haroon