Abstract
Physical, psychological and cognitive symptoms have been reported as post-acute sequelae for COVID-19 patients but are also common in the general uninfected population. We aimed to calculate the excess risk and identify patterns of 22 symptoms up to 12 months after COVID-19. We followed more than 70,000 adult participants in an ongoing cohort study, the Norwegian Mother, Father and Child Cohort Study (MoBa) during the COVID-19 pandemic. Infected and non-infected participants registered presence of 22 different symptoms in March 2021. One year after infection, 13 of 22 symptoms were associated with SARS-CoV-2 infection, based on relative risks between infected and uninfected subjects. For instance, 17.4% of SARS-CoV-2 infected cohort participants reported fatigue that persist 12 months after infection, compared to new occurrence of fatigue that had lasted less than 12 months in 3.8% of non-infected subjects (excess risk 13.6%). The adjusted relative risk for fatigue was 4.8 (95% CI 3.5–6.7). Two main underlying factors explained 50% of the variance in the 13 symptoms. Brain fog, poor memory, dizziness, heart palpitations, and fatigue had high loadings on the first factor, while shortness-of breath and cough had high loadings on the second factor. Lack of taste and smell showed low to moderate correlation to other symptoms. Anxiety, depression and mood swings were not strongly related to COVID-19. Our results suggest that there are clusters of symptoms after COVID-19 due to different mechanisms and question whether it is meaningful to describe long COVID as one syndrome.
Highlights
In light of the many million people infected by SARSCoV-2, it is important to understand the long-term physical, psychological and cognitive consequences for infected subjects in a population perspective
774 (1.0%) of the 73,727 included cohort participants were infected with SARS-CoV-2 in the study period
This allows for measures of association between infection and symptoms, using both risk differences and relative risks
Summary
In light of the many million people infected by SARSCoV-2, it is important to understand the long-term physical, psychological and cognitive consequences for infected subjects in a population perspective. How common are the symptoms that persist or occur after infection, how long will they last, and what do they consist of? Since reported symptoms are mostly of a general nature, apart from altered smell and taste, one must take account of the incidence of these complaints in the uninfected population. We compare the proportion of new symptoms for participants with and without COVID-19, calculating excess risks for each symptom. We show the number of symptoms reported by each participant and examine the symptom profile for participants. We compare risks for men and women, and for subjects with and without severe disease
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