PuSH - Publication Server of Helmholtz Zentrum München: Persistent symptoms and risk factors predicting prolonged time to symptom-free after SARS‑CoV‑2 infection: An analysis of the baseline examination of the German COVIDOM/NAPKON-POP cohort.

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Shi, Y.* ; Strobl, R.* ; Apfelbacher, C.* ; Bahmer, T.* ; Geißler, R.* ; Heuschmann, P.* ; Horn, A.* ; Hoven, H.* ; Keil, T.* ; Krawczak, M.* ; Krist, L.* ; Lemhöfer, C.* ; Lieb, W.* ; Lorenz-Depiereux, B. ; Mikolajczyk, R.* ; Montellano, F.A.* ; Reese, J.P.* ; Schreiber, S.* ; Skoetz, N.* ; Störk, S.* ; Vehreschild, J.J.* ; Witzenrath, M.* ; Grill, E.*

Persistent symptoms and risk factors predicting prolonged time to symptom-free after SARS‑CoV‑2 infection: An analysis of the baseline examination of the German COVIDOM/NAPKON-POP cohort.

Infection 51, 1679-1694 (2023)

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Open Access Green as soon as Postprint is submitted to ZB.

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PURPOSE: We aimed to assess symptoms in patients after SARS-CoV-2 infection and to identify factors predicting prolonged time to symptom-free. METHODS: COVIDOM/NAPKON-POP is a population-based prospective cohort of adults whose first on-site visits were scheduled ≥ 6 months after a positive SARS-CoV-2 PCR test. Retrospective data including self-reported symptoms and time to symptom-free were collected during the survey before a site visit. In the survival analyses, being symptom-free served as the event and time to be symptom-free as the time variable. Data were visualized with Kaplan-Meier curves, differences were tested with log-rank tests. A stratified Cox proportional hazard model was used to estimate adjusted hazard ratios (aHRs) of predictors, with aHR < 1 indicating a longer time to symptom-free. RESULTS: Of 1175 symptomatic participants included in the present analysis, 636 (54.1%) reported persistent symptoms after 280 days (SD 68) post infection. 25% of participants were free from symptoms after 18 days [quartiles: 14, 21]. Factors associated with prolonged time to symptom-free were age 49-59 years compared to < 49 years (aHR 0.70, 95% CI 0.56-0.87), female sex (aHR 0.78, 95% CI 0.65-0.93), lower educational level (aHR 0.77, 95% CI 0.64-0.93), living with a partner (aHR 0.81, 95% CI 0.66-0.99), low resilience (aHR 0.65, 95% CI 0.47-0.90), steroid treatment (aHR 0.22, 95% CI 0.05-0.90) and no medication (aHR 0.74, 95% CI 0.62-0.89) during acute infection. CONCLUSION: In the studied population, COVID-19 symptoms had resolved in one-quarter of participants within 18 days, and in 34.5% within 28 days. Over half of the participants reported COVID-19-related symptoms 9 months after infection. Symptom persistence was predominantly determined by participant's characteristics that are difficult to modify.

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