Background
Objective
Methods
Study design and sample
Post-COVID syndrome score (PCS score) mapping and enhancement
Assessment of functional impairments and quality of life
Data analysis
Results
Patient characteristics
Total | PCS scorea | p valueb | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
0 (none) | > 0 to ≤ 10.75 (mild) | > 10.75 to ≤ 26.25 (moderate) | > 26.25 (severe) | Unadjusted | Adjusted | |||||||
n (%) | 603 | (100.0) | 215 | (35.7) | 120 | (19.9) | 221 | (36.7) | 47 | (7.8) | ||
Age [years], mean (SD)c,d | 54.0 | (16.1) | 52.0 | (17.1) | 54.9 | (17.3) | 55.3 | (14.9) | 54.7 | (12.1) | 0.207 | n.a |
Age groups, n (%)c,d | ||||||||||||
< 65 years | 438 | (72.9) | 155 | (72.1) | 82 | (68.9) | 163 | (74.1) | 38 | (80.9) | 0.442 | n.a |
≥ 65 years | 163 | (27.1) | 60 | (27.9) | 37 | (31.1) | 57 | (25.9) | 9 | (19.1) | ||
Sex n (%)c,d | ||||||||||||
Women | 237 | (39.4) | 70 | (32.6) | 48 | (40.3) | 91 | (41.2) | 28 | (59.6) | 0.006* | 0.034* |
Men | 365 | (60.6) | 145 | (67.4) | 71 | (59.7) | 130 | (58.8) | 19 | (40.4) | ||
BMI [kg/m2], mean (SD)c,d | 27.9 | (6.1) | 27.5 | (6.0) | 27.2 | (6.0) | 28.4 | (6.1) | 28.9 | (5.9) | 0.077 | n.a |
Smoker, n (%)d | ||||||||||||
Never | 349 | (59.1) | 126 | (61.2) | 69 | (58.0) | 127 | (58.0) | 27 | (57.4) | 0.899 | n.a |
Yes or former | 242 | (40.9) | 80 | (38.8) | 50 | (42.0) | 92 | (42.0) | 20 | (42.6) | ||
Clinical Severity (following WHO criteria), n (%)c,e | ||||||||||||
Mild disease (no hospitalization) | 108 | (18.0) | 50 | (23.3) | 25 | (21.0) | 27 | (12.3) | 6 | (12.8) | 0.038* | 0.687 |
Moderate disease (hospitalized, no oxygen or oxygen by mask or nasal prongs (< 15 l/min)) | 407 | (67.8) | 140 | (65.1) | 73 | (61.3) | 158 | (72.1) | 36 | (76.6) | ||
Severe disease (hospitalized, oxygen by NIV or high flow (> 15 l/min)) | 85 | (14.2) | 25 | (11.6) | 21 | (17.6) | 34 | (15.5) | 5 | (10.6) | ||
Hospitalized, n (%)c,e | ||||||||||||
No | 108 | (18.0) | 50 | (23.3) | 25 | (21.0) | 27 | (12.3) | 6 | (12.8) | 0.015* | 0.093 |
Yes | 492 | (82.0) | 165 | (76.7) | 94 | (79.0) | 192 | (87.7) | 41 | (87.2) | ||
Admission to intensive care unit (ICU), n (%) c,e | ||||||||||||
Never | 398 | (83.3) | 140 | (84.8) | 76 | (80.9) | 159 | (82.8) | 37 | (90.2) | 0.514 | n.a |
At least once | 80 | (16.7) | 25 | (15.2) | 18 | (19.1) | 33 | (17.2) | 4 | (9.8) | ||
At least one vaccination against Sars-COV-2 prior to study inclusion, n (%)c,h | ||||||||||||
No | 313 | (56.6) | 101 | (51.8) | 67 | (61.5) | 117 | (56.8) | 28 | (65.1) | 0.245 | n.a |
Yes | 240 | (43.4) | 94 | (48.2) | 42 | (38.5) | 89 | (43.2) | 15 | (34.9) | ||
All reported vaccination against SARS-CoV-2 prior to study inclusion, n (%)b,c | ||||||||||||
No | 215 | (54.6) | 60 | (45.1) | 49 | (62.8) | 96 | (60.4) | 10 | (41.7) | 0.013* | 0.080 |
Yes | 179 | (45.4) | 73 | (54.9) | 29 | (37.2) | 63 | (39.6) | 14 | (58.3) | ||
No.of vaccinations per patient, mean (SD)c, i | 1.6 | (1.3) | 2.2 | (0.9) | 2.2 | (1.0) | 2.2 | (0.9) | 2.3 | (1.1) | 0.977 | n.a |
0, n (%) | 159 | (28.4) | 62 | (31.3) | 31 | (27.9) | 47 | (22.6) | 19 | (44.2) | 0.224 | n.a |
1, n (%) | 98 | (17.5) | 33 | (16.7) | 23 | (20.7) | 35 | (16.8) | 7 | (16.3) | ||
2, n (%) | 157 | (28.0) | 53 | (26.8) | 28 | (25.2) | 68 | (32.7) | 8 | (18.6) | ||
3 or more, n (%) | 146 | (26.1) | 50 | (25.3) | 29 | (26.1) | 58 | (27.9) | 9 | (20.9) | ||
Quality of life (EQ-5D-5L) at 3MFU, mean (SD)c | ||||||||||||
Index (0–1) | 0.8 | (0.2) | 0.9 | (0.2) | 0.9 | (0.2) | 0.8 | (0.2) | 0.7 | (0.2) | < 0.001* | < 0.001* |
VAS (0–100 points) | 73.9 | (20.3) | 86.4 | (13.7) | 75.8 | (20.5) | 65.8 | (19.7) | 60.3 | (17.1) | < 0.001* | < 0.001* |
No. of pre-existing comorbidities, mean (SD)j,k,l | 1.9 | (1.9) | 1.5 | (1.6) | 2.1 | (2.1) | 2.0 | (2.0) | 2.1 | (2.0) | 0.016* | 0.098 |
0, n (%) | 177 | (29.4) | 74 | (34.4) | 35 | (29.2) | 56 | (25.3) | 12 | (25.5) | 0.194 | n.a |
1 or more, n (%) | 426 | (70.7) | 141 | (65.6) | 85 | (70.8) | 165 | (74.7) | 35 | (74.5) | ||
1–2, n (%) | 252 | (41.8) | 92 | (42.8) | 45 | (37.5) | 93 | (42.1) | 22 | (46.8) | ||
3–5, n (%) | 138 | (22.9) | 43 | (20.0) | 28 | (23.3) | 58 | (26.2) | 9 | (19.1) | ||
6 or more, n (%) | 36 | (6.0) | 6 | (2.8) | 12 | (10.0) | 14 | (6.3) | 4 | (8.5) | ||
Pre-existing comorbidities n (%)c,j,k,l | ||||||||||||
Cardiovascular diseases | 278 | (46.1) | 94 | (43.7) | 62 | (51.7) | 103 | (46.6) | 19 | (40.4) | 0.454 | n.a |
Diabetes | 101 | (16.8) | 29 | (13.6) | 29 | (24.2) | 34 | (15.5) | 9 | (19.1) | 0.081 | n.a |
Cancer | 103 | (17.1) | 35 | (16.3) | 16 | (13.3) | 41 | (18.6) | 11 | (23.4) | 0.394 | n.a |
Allergies | 90 | (15.0) | 29 | (13.6) | 21 | (17.5) | 34 | (15.4) | 6 | (13.0) | 0.772 | n.a |
Respiratory diseases | 74 | (12.3) | 10 | (4.7) | 14 | (11.7) | 42 | (19.0) | 8 | (17.0) | < 0.001* | < 0.001* |
Nephrological diseases | 64 | (10.6) | 19 | (8.8) | 14 | (11.7) | 23 | (10.4) | 8 | (17.0) | 0.383 | n.a |
Gastrointestinal or hepatic diseases | 40 | (6.6) | 11 | (5.1) | 8 | (6.7) | 18 | (8.1) | 3 | (6.4) | 0.654 | n.a |
Organ transplant | 35 | (5.8) | 14 | (6.5) | 8 | (6.7) | 10 | (4.5) | 3 | (6.4) | 0.734 | n.a |
Psychiatric diseases | 35 | (5.8) | 7 | (3.3) | 3 | (2.5) | 21 | (9.5) | 4 | (8.7) | 0.009* | 0.056 |
Neurological diseases | 23 | (3.8) | 7 | (3.3) | 5 | (4.2) | 7 | (3.2) | 4 | (8.5) | 0.330 | n.a |
Rheumatologic or immunologic diseases | 13 | (2.2) | 1 | (0.5) | 2 | (1.7) | 8 | (3.6) | 2 | (4.3) | 0.058 | n.a |
PROMIS-29 Ability to participate in social roles and activities, mean (SD)c,d | 15.4 | (4.6) | 19.0 | (2.0) | 16.5 | (4.1) | 13.2 | (4.4) | 11.7 | (3.8) | < 0.001* | < 0.001* |
No social impairments, n (%) | 297 | (71.6) | 113 | (98.3) | 74 | (87.1) | 96 | (54.5) | 14 | (35.9) | < 0.001* | < 0.001* |
Social impairments, n (%) | 118 | (28.4) | 2 | (1.7) | 11 | (12.9) | 80 | (45.5) | 25 | (64.1) | ||
PROMIS-29 Physical function, mean (SD) c,d | 16.9 | (4.0) | 19.4 | (1.5) | 17.4 | (3.7) | 15.5 | (4.3) | 14.2 | (4.2) | < 0.001* | < 0.001* |
No physical impairments, n (%) | 253 | (60.0) | 111 | (93.3) | 57 | (64.8) | 73 | (41.2) | 12 | (31.6) | < 0.001* | < 0.001* |
Physical impairments, n (%) | 169 | (40.0) | 8 | (6.7) | 31 | (35.2) | 104 | (58.8) | 26 | (68.4) |
Symptom complexes and Post-COVID syndrome score (PCS score)
No | Symptom complex | Self-reported sub-symptoms | Without PROMs | With PROMs | ||
---|---|---|---|---|---|---|
n | (%) | n | (%) | |||
1 | Chemosensory deficitsa,b | Smelling disturbance, impaired sense of taste | 73 | (9.4) | 73 | (9.4) |
2 | Fatigueb | Fatigue | 68 | (8.3) | 341 | (41.1) |
3 | Exercise intolerance | Shortness of breath | 150 | (20.3) | 307 | (39.7) |
4 | Joint or muscle paina,b | Muscle pain, joint pain | 60 | (7.7) | 60 | (7.7) |
5 | Ear-Nose-Throat (ENT) ailmentsa,b | Sneezing, sore throat, running nose, stuffy nose | 37 | (4.7) | 37 | (4.7) |
6 | Coughing, wheezinga,b | Coughing, wheezing | 82 | (10.4) | 82 | (10.4) |
7 | Chest painb | Chest pain | 21 | (2.8) | 79 | (10.2) |
8 | Gastrointestinal ailmentsb | Stomach pain, diarrhea, vomiting, nausea | 38 | (4.6) | 74 | (9.0) |
9 | Neurological ailmentsb | Confusion, vertigo, headache, deficits of cognition | 98 | (12.2) | 321 | (39.4) |
10 | Dermatological ailmentsa,b | Skin or mucous membrane change | 12 | (1.6) | 12 | (1.6) |
11 | Infection signsa,b | Chills, fever, feeling ill, lymph node swelling, loss of appetite | 39 | (4.7) | 39 | (4.7) |
12 | Sleep disturbanceb | Sleep disturbance, not elsewhere classified | 0 | (0.0) | 140 | (16.4) |