Abstract
Background: Various symptoms persist even after the acute symptoms in about one third of patients with COVID-19. In February 2021, we established an outpatient clinic in a university hospital for patients with long COVID and started medical treatment for sequelae that persisted one month or more after infection. Methods: To determine the key factors that affect the onset and clinical course of sequelae, a retrospective analysis was performed at Okayama University Hospital (Japan) between February and July 2021. We focused on changes in the numbers of symptoms and the background of the patients during a three-month period from the first outpatient visit. We also examined the relationship with SARS-CoV-2 antibody titers. Results: Information was obtained from medical records for 65 patients. The symptoms of sequelae were diverse, with more than 20 types. The most frequent symptoms were general malaise, dysosmia, dysgeusia, sleeplessness, and headache. These symptoms improved in about 60% of the patients after 3 months. Patients who required hospitalization and had a poor condition in the acute phase and patients who received oxygen/dexamethasone therapy had higher antibody titers at the time of consultation. Patients with antibody titers ≥200 U/mL showed significantly fewer improvements in long COVID symptoms in 1 month, but they showed improvements at 3 months after the first visit. Conclusion: Long COVID symptoms were improved at 3 months after the initial visit in more than half of the patients. Serum antibody titers were higher in patients who experienced a severe acute phase, but the serum antibody titers did not seem to be directly related to the long-term persistence of long COVID symptoms.
Highlights
The novel coronavirus disease 2019 (COVID-19) pandemic is ongoing almost 2 years after the declaration of a pandemic by the World Health Organization (WHO) [1]
Information was obtained from medical records for age, gender, body mass index (BMI), underlying conditions, hospitalization due to COVID-19, therapeutic events of either oxygen or corticosteroid use during the acute phase, date of visiting the COVID-19 aftercare clinic (CAC) after the onset of COVID-19, severity of COVID-19, history of COVID-19 vaccination, and clinical symptoms of long COVID
A notable point of our study is that we investigated the associations between serum antibody titers and long COVID symptoms
Summary
The novel coronavirus disease 2019 (COVID-19) pandemic is ongoing almost 2 years after the declaration of a pandemic by the World Health Organization (WHO) [1]. In addition to acute-phase symptoms, COVID-19 can cause prolonged sequelae, which have recently been termed as long COVID or post-acute sequelae of SARS-CoV-2 infection (PASC) and have recently been defined as post-COVID-19 condition by WHO [10–12]. At least one-third of COVID-19 patients have long COVID [17,18], and an effective treatment strategy for long COVID has not yet been established. Our previous study revealed that (i) most patients with long COVID had not required hospitalization in the acute phase and (ii) general fatigue was a major complaint in more than half of the patients [21]. We analyzed follow-up data over a 3-month period for patients with long COVID who visited our clinic, in order to determine how each of the sequelae deteriorated or improved. We examined serum antibody titers in all of the patients to determine whether antibody titers can be a clue for estimating the prognosis of sequelae
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