Acute COVID-19 Research Articles

Spatial Distribution and Post-COVID-19 Health Complications in Older People: A Brazilian Cohort Study.

Background/Objectives: In the aftermath of the COVID-19 pandemic, individuals infected with SARS-CoV-2 have progressively displayed a range of symptoms linked to protracted COVID during the post-acute phase of illness. Concurrently, in several nations globally, the phenomenon of population aging has been intensifying. In this scenario, the aged population has become both vulnerable and high-risk during the acute phase of COVID-19, and faces significant dangers associated with long-COVID. This study seeks to analyze the incidence and spatial distribution of health complications in older people affected by COVID-19, in the first year of the pandemic (2020), in the State of Paraná, as well as to identify the factors associated with the development of cardiovascular, neurological, respiratory, and metabolic diseases. Method: An observational and retrospective study was carried out in the Brazilian state of Paraná. Participants were randomly selected from two databases. A total of 893 older people (≥60 years) participated in the study 12 months after acute COVID-19 infection. Telephone questionnaires were applied between March and December 2021. The Moran index test, logistic regression, and Poisson models were used to analyze the data. Results: In terms of age, most participants (66%) were between 60 and 69 years old, 25.8% were between 70 and 79 years old, and 8.2% were 80 years old or older. Most participants were female (51.2%), white (98.1%), had a partner (69.8%), and had been hospitalized due to COVID-19 (59.3%). Cardiovascular diseases were the most frequent in the population (39.5%), followed by metabolic diseases (27.3%). The long-term use of medication was associated with the development of metabolic diseases (aOR = 9.8), cardiovascular diseases (aOR = 6.6), and diseases in multiple organic systems (aOR = 3.2); living alone was associated with neurological diseases (aOR = 2.5), and the age group of 80 years or older (aOR = 2.4) was associated with cardiovascular events. The spatial distribution showed that complications in body groups are distributed randomly among the health regions of the state, with no influence from neighboring locations. Conclusions: Post-COVID-19 health complications are more frequent in older adults who have comorbidities and long-term medication use. Therefore, long-term monitoring of these individuals and investment in public policies for rehabilitation and prevention of complications are necessary.

Clinical characteristic and outcomes of pregnant women with COVID‐19: The PROUDEST prospective cohort study

The present study intended to characterize the clinical features and outcomes of SARS-CoV-2 infection at distinct pregnancy trimesters. A total of 260 pregnant women with SARS-CoV-2 infection at any pregnancy trimester were enrolled in a prospective follow-up study. Clinical features were recorded between the SARS-CoV-2 infection diagnosis towards delivery and postpartum period. ANOVA and Chi-square/Fisher tests, Bi- and multivariate analyses were performed to verify the effect of predictors on disease outcome, adjusted for the pregestational variables. Data demonstrated that anosmia (64.6%), nasal congestion/discharge (61.5%), headache (60.8%), ageusia (58.5%) and myalgia (58.5%) were the most common symptoms observed amongst pregnant women with non-severe COVID-19. Fever (44.6%) and dyspnea (36.5%) were associated with higher disease severity. Gestational diabetes mellitus (35.8%), systemic arterial hypertension (18.1%), preterm delivery (11.5%) and superimposed preeclampsia (6.2%) were reported as adverse pregnancy outcomes amongst pregnant women with COVID-19. Parturients with acute COVID-19 and pregnant women infected at the 3rd trimester presented more severe or critical outcomes as compared to those infected at 2nd and 1st trimesters. Preterm labor (Odds Ratio = 3.64), acute fetal distress (Prevalence Ratio = 2.40) and Apgar 1st minute score ≤ 7 (Prevalence Ratio = 2.56) were adverse outcomes reported in parturients with acute COVID-19 and those with severe or critical outcomes. Together these findings demonstrated that SARS-CoV-2 infection during pregnancy was associated with relevant maternal and neonatal adverse outcomes. The understanding of the clinical and obstetric outcomes of COVID-19 during pregnancy can provide insights to establish the most suitable approach for clinical management of pregnant women.

Respiratory function and sleep parameters in adults following recovery from acute COVID-19.

Respiratory function and sleep parameters in adults following recovery from acute COVID-19.

Luteolin: A potential therapeutic agent for respiratory diseases.

Luteolin: A potential therapeutic agent for respiratory diseases.

Gene expression profile of immune response markers associated with long COVID and its clinical aspects in a cohort from northern Brazil.

Gene expression profile of immune response markers associated with long COVID and its clinical aspects in a cohort from northern Brazil.

Epstein-Barr virus (EBV) reactivation in post COVID-19.

Epstein-Barr virus (EBV) reactivation in post COVID-19.

Real-time monitoring of excess mortality under a new endemic regime.

BACKGROUNDMonitoring of mortality to identify trends and detect deviations from normal levels is an essential part of routine surveillance. In many European countries, disruptions in mortality patterns from the COVID-19 pandemic have required revisions to expected mortality estimates (and models) in the current endemic phase of SARS-CoV-2.AIMTo identify essential characteristics for future mortality surveillance and describe two Bayesian methods that satisfy these criteria while being robust to past periods of high COVID-19 mortality. We demonstrate their application in 19 European countries and subnational estimates in the United States, and report measures of model calibration.METHODSWe used a generalised additive model (GAM) with smoothed spline terms for annual trend and within-year seasonality and a generalised linear model (GLM) with a Serfling component for within-year seasonality and breakpoints to detect trend changes in trend. Both approaches modelled change in population size and group-specific (age and sex) mortality patterns.RESULTSModels were well-calibrated and able to estimate national and group-specific mortality before and during the acute COVID-19 pandemic phase. The effect of inclusion of mortality from the acute pandemic period was primarily an increase in uncertainty in expected mortality over the projection period. The GAM approach had better calibration and less variability in bias among countries.CONCLUSIONModels that can adapt to mortality anomalies seen during the acute COVID-19 pandemic period without a need for adjustments to observational data, or tailoring of model specifications, are feasible. The proposed methods can complement operational national and inter-agency surveillance systems currently used in Europe.

Prevalence and prognosis of sarcopenia in acute COVID-19 and long COVID: a systematic review and meta-analysis

Background A comprehensive investigation delineating the prevalence of sarcopenia across different infection phases, from acute COVID-19 to long COVID, is lacking. Meanwhile, the relationship between sarcopenia and adverse outcomes among COVID-19 patients remains inconsistent. Materials and methods A systematic search of MEDLINE/PubMed, Embase, Cochrane Library, Web of Science, and Scopus, before 22nd February 2025, was conducted to identify studies assessing sarcopenia prevalence in acute COVID-19 and long COVID. Random effects meta-analyses were performed to estimate the pooled prevalence of sarcopenia for acute COVID-19 and long COVID patients. Subgroup analyses stratified by assessment tool, region, income, hospitalization status, and age were performed. The associations between sarcopenia and COVID-19-related clinical outcomes were further quantified. Results A total of 39 studies with 6,982 individuals were included. The pooled prevalence of sarcopenia was 48.7% (95% confidence interval (CI): 39.6–57.9%) in acute COVID-19 and 23.5% (95% CI: 12.7–39.4%) in long COVID. In acute COVID-19 patients, sarcopenia was not significantly associated with length of stay (mean difference = 2.215, 95% CI: −0.004 to 4.433), mechanical ventilation (Odds ratio (OR) = 1.80, 95% CI: 0.84–3.85), admission to the intensive care unit (OR = 1.05, 95% CI: 0.63–1.77), or mortality (OR = 1.41, 95% CI: 0.86–2.32), but was significantly associated with tracheostomy (OR = 2.48, 95% CI: 1.28–4.82). Conclusion In conclusion, our findings indicate that sarcopenia is highly prevalent in acute COVID-19 and persists in a substantial proportion of long COVID patients, suggesting prolonged muscle loss beyond the acute phase. Future well-designed studies are needed to further investigate the association between sarcopenia and short-term and long-term prognostic outcomes in both acute and long COVID patients.

The dynamics of respiratory changes on the background of inhalation treatment with tauractant in patients in the post-covid period

Introduction. Pulmonary surfactant is a key component of the respiratory system that ensures the stability of the alveoli by reducing surface tension, preventing collapse of the respiratory tract and protecting against infections. Its dysfunction is observed in severe respiratory diseases, including COVID-19, ARDS, pneumonia, COPD and bronchial asthma. Of particular interest is the inhalation use of exogenous forms of surfactant not only in acute COVID-19, but also in the post-covid period.Aim. The aim of the study is to evaluate the effectiveness of a course of inhalation of tauractant emulsion (Surfactant-BL) through a nebulizer in patients with COVID-associated pneumonia with persistent ventilation disorders after 3 months of therapy in the post-covid period.Materials and methods: The study included 60 patients with COVID-associated pneumonia with confirmed violations of lung ventilation and pronounced residual changes in lung tissue, who were randomly divided into 2 groups – the main group (n = 30) and the comparison group (n = 30). The main group, in addition to the standard therapy for post-covid syndrome, received a course of inhalation with Surfactant-BL twice a day for 7 days. All patients underwent a comprehensive study of respiratory function (spirography, bodyplethysmography and diffusion test) at the stage of inclusion in the study and after 3 months.Results. In the main group, significant positive dynamics in FEV1, FEV1/FVC, FRC, and TLC were revealed, while the diffusion capacity DLCO of the lungs did not significantly change.Conclusion. In this study, the effectiveness of the use of an exogenous surfactant in the post-pregnancy period was demonstrated. It is advisable to continue conducting studies using more numerous groups of patients to determine clear criteria for the use of inhaled surfactant therapy in the post-covid period.

Frequent Menstrual Disturbance Post-COVID-19 Vaccination in Saudi Arabia

The increased menstrual disturbances post-vaccination remain unclear. We examined factors, types, frequencies, and emotional challenges. We used a self-administered online questionnaire with the IBM-based SPSSv-24-Windows software for analysis. Of 1372 females, 61.1% (n = 838) were aged 19–29 years, 94.2% (n = 1292) were Saudis, 66.4% (n = 911) were graduates, 70% (n = 965) were single, and 15% (n = 205) had chronic diseases. Moreover, 96.5% (n = 1285/1332) had two vaccine doses, mostly Pfizer’s first- and second doses (82% and 78, respectively), while 3.5% (n = 47) only had one. Vaccine groups significantly differed (Pfizer, Moderna, Oxford, and do not know) after the first (0.047) and second (0.049) doses, while Pfizer vaccines were predictive [OR = 2.09 (0.96–4.10), p = 0.029] at two-doses [OR = 3.21 (1.23–5.21), p = 0.030]. No acute COVID appeared. The majority (77%; n = 1057) had no issues, except, in a subgroup of 23% (n = 315) of participants, 43% (n = 135) experienced worsening issues. However, 47.2% (n = 629) complained only post vaccination. Most issues were (75%; n = 471) cycle-timing disruptions; the rest were minor (decreased blood or bleeding, missed-periods, or pain). Other potential reasons were fear, stress, and mental health problems, which occurred in 51% (n = 674) of the group, while 53% (n = 701) were worried. Intriguingly, the menstrual issues in the remaining 47% (n=631) who were not worried could be due to a direct molecular vaccine interaction, irrespective of any mental issue ([OR = 1.78 (0.76–3.21), p = 0.033]. Age proportionalities were significant (p = 0.05) in the 30–39 year-old group (51%). Postgraduate education [OR = 2.11 (0.98–4.72), p = 0.015) and employment [OR = 2.18 (0.95–4.86), p = 0.049] were also predictors. These findings have significant implications in women’s health and vaccine improvement. Future studies on diverse factors are warranted.

Prevalence and Predictors of Long COVID During the Omicron Variant Dominant Epidemic at 3 and 6 Months in Thailand

Background Long Covid is defined as conditions that continue or develop after acute COVID-19 infection more than 3 months. This study aimed to analyze the point prevalence and predictors of long Covid in the Omicron variant dominant epidemic at 3 and 6 months in Thailand. Methods Prospective cohort study on the COVID-19 cohort at Thammasat University Hospital (TUH) and Thammasat Field Hospital (TFH) during the Omicron variant dominant epidemic was performed. The phone interview for long Covid symptoms was performed among 1,388 patients at 3 months and 917 patients at 6 months after the infection. Clinical characteristics of all participants were retrieved from the database of the hospital. Results The point prevalence of long Covid was 52.59% at 3 months and 28.57% at 6 months. The most prevalent symptom group at both time points was fatigue and weakness, affecting 31.70% of patients at 3 months and 15.81% at 6 months. Three significant predictors of long Covid were identified at both 3 and 6 months: severe-to-critical illness during the acute phase, female sex, and healthcare worker occupation. The adjusted odds ratios (aOR) for severe-to-critical illness were 4.50 [95% CI, 1.59–12.75] at 3 months and 9.15 [95% CI, 1.35–62.10] at 6 months. Female sex was associated with aORs of 2.04 [95% CI, 1.61–2.58] at 3 months and 2.41 [95% CI, 1.71–3.34] at 6 months. Healthcare workers had aORs of 1.96 [95% CI, 1.39–2.78] at 3 months and 3.12 [95% CI, 1.85–5.27] at 6 months. Obesity was a significant predictor of long Covid only at 3 months. Conclusions The prevalence of long Covid remains substantial following the Omicron variant-dominant epidemic. Key predictors of long Covid at both 3 and 6 months include severe-to-critical illness during the acute phase, female sex, and healthcare worker occupation.

Long-term renal consequences of COVID-19. Emerging evidence and unanswered questions.

COVID-19 infection is associated with a high burden of acute or acute on chronic kidney injury (AKI), particularly in critically ill patients. Given the large numbers of COVID-19 survivors, characterization of long-term adverse kidney effects of COVID-19 have important implications for post-COVID-19 care. This narrative review provides a summary of epidemiologic evidence for post-COVID kidney disorders. Precise post-COVID renal data are scarce. The true burden of long-COVID chronic kidney disease (CKD) remains unknown owing to under-recognition, under-diagnosis, clinical heterogeneity of patients, incomplete follow-up, and temporal trends in critical COVID-19 disease across waves of the pandemic. Collectively, the few well-designed studies assessing the impact of long-COVID on kidney health found that the overwhelming majority of patients with normal renal function at admission and without AKI during acute COVID-19 disease preserved kidney function. Post-infection kidney function trajectories of patients who experience a loss of renal function vary. Kidney function may decline gradually even in non-hospitalized patients, hospitalized patients may experience a rapid loss of kidney function 6-12months after COVID-19 diagnosis or hospital discharge resulting from AKI during the acute phase of the disease. End-stage renal disease may occur after non-recovery from AKI and rapid progression of pre-existing CKD. Multiple mechanisms may trigger post-COVID CKD including maladaptive repair after AKI, or progression of renal lesions of systemic co-morbidities, persistence of the virus and dysregulation of inflammatory cytokines. The COVID-19 pandemic has significantly impacted and may continue to have an impact on kidney health. Patients at risk have a higher propensity to develop critical COVID-19 disease. Post-COVID-19 care must pay close attention to renal function in patients discharged from hospital.

Body Mass Index and COVID-19: An Overview Among an Italian Multicentric Cohort of Healthcare Workers in the Pre- and Post-Vaccination Eras—ORCHESTRA Project

Background The prevalence of obesity is increasing all over the world, resulting in a global health emergency. The impact of obesity on the risk of SARS-CoV-2 infection and symptom severity, especially among high-risk working populations such as health workers, deserves further studies. Methods A multicentric retrospective cohort study was conducted among health workers at four Italian University Hospitals belonging to the ORCHESTRA Project. Data were collected through an online survey, investigating sociodemographic and clinical data, until September 2022. Results The questionnaire was filled out by 5777 health workers. The median age was 46 years old (I–III quartile 20–72) and 75.5% were females. Data on BMI was available for 5470 participants. Overweight and obese subjects amounted to 23.4% and 9.8%, respectively. Naïve health workers were the majority (57.4%). Overweight and obese subjects were at a higher risk of infection only before vaccination with respect to normoweight subjects (RRR = 1.28 (IC 95% 1.01–1.62, p = 0.039) and 1.36 (1.00–1.86, p = 0.047), respectively). Major acute and post-acute COVID-19 symptoms were more common among obese subjects, as compared to those with a normal weight (35.2% vs. 23.5%, and 14.2% vs. 9.3%). BMI did not reduce antibody levels after vaccination. On the contrary, overweight and obese health workers had a significantly higher RGM after the third dose (1.12 and 1.48, respectively; normal weight as reference). Conclusions Overweight and obese subjects are at a higher risk of SARS-CoV-2 infection. However, SARS-CoV-2 vaccination fosters a high antibody response even in these individuals. Vaccination against SARS-CoV-2 should be prioritized in subjects with a high BMI, especially in highly exposed workers, such as health workers.

Post-Acute Sleep Disturbances Following COVID-19 and Associated Factors: A Single-Center Study

Backgrounds: The long-term effects of COVID-19 infection on survivors' mental health and its relationship with COVID-19 severity remain undetermined. We aimed to investigate the post-COVID sleep disturbances (poor sleep quality and insomnia) that persist beyond four weeks after acute COVID-19 infection and up to six months after the acute illness and the related factors. Methods: We enrolled 188 participants 1-6 months after COVID-19 infection in this cross-sectional study. All participants were asked to complete a sociodemographic data form, the Beck Anxiety Scale (Beck-A), the Beck Depression Scale (Beck-D), the Pittsburgh Sleep Quality Index (PSQI), and the Insomnia Severity Index (ISI). Results: 43.6% and 41% of participants reported experiencing poor sleep quality and insomnia, respectively. Sociodemographic factors such as marital and employment status, education level, household size, smoking, alcohol consumption, follow-up time, and comorbidities did not significantly impact sleep quality and insomnia rates. However, our study's results showed that higher anxiety and depression scores were associated with worse sleep quality and insomnia. Conclusions: Our study highlights the critical situation of sleep disturbances, anxiety, and depression risk in post-COVID-19 patients. Although the first COVID-19 pandemic has ended, analyzing worldwide data about the last pandemic is crucial for preparing for potential scenarios globally.

Eustachian Valve Endocarditis Secondary to Candida glabrata Complicated by Frailty and Acute COVID-19 Infection

Eustachian Valve Endocarditis Secondary to Candida glabrata Complicated by Frailty and Acute COVID-19 Infection

Two-year follow-up of patients with myocardial injury during acute COVID-19: insights from the CARDIO COVID 20-21 registry.

COVID-19 can cause Myocardial Injury (MI) during acute illness, which has been strongly associated with worse outcomes during hospitalization, however, more research is required on its effects on long-term outcomes, especially in underexplored regions in the literature such as Latin America. This multicenter prospective cohort study follows up with patients with previous severe COVID-19 at a 2-year follow-up encounter. Comprehensive assessments were conducted including demographic data, clinical variables, psychiatric evaluations, and echocardiographic studies. Patients were stratified by the presence or absence of MI during their acute COVID-19 hospitalization. Statistical analyses included logistic regression and univariate comparisons. Of the 210 patients included, 53 (25%) had MI. Patients with MI were older, had a higher prevalence of comorbidities (e.g., hypertension, chronic kidney disease, atrial fibrillation), and were more likely to require intensive care unit admission, invasive mechanical ventilation, and vasopressor or inotropic support during acute COVID-19. Regarding long-term cardiovascular outcomes, no significant differences were observed in de novo cardiovascular disease, venous thromboembolism, or acute cardiovascular events. Patients with MI had greater odds of cardiopulmonary hospitalizations during follow-up (aOR 3.67, 95% CI 1.07-13.07, p = 0.037) after adjusting for age and sex. Patients with prior MI during COVID-19 had a higher prevalence of comorbidities, poorer functional status, and increased odds of cardiopulmonary hospitalizations over a two-year follow-up evaluation compared to those without MI. Although prior studies suggest an association between MI and worse long-term outcomes, the evidence remains inconsistent. These findings emphasize the need for ongoing research to clarify how MI contributes to worsened long-term outcomes.

Impact of antifibrotics on post-COVID-19 lung sequelae.

Respiratory problems in acute COVID-19 and post-acute COVID-19 syndrome vary greatly, potentially leading to long-term functional difficulties. Off-label usage of antifibrotics, such as pirfenidone, has emerged as a promising treatment for post-COVID interstitial lung problems. Our study aims to assess clinical and radiological lung abnormalities post-COVID-19 and the effect of antifibrotics on the outcome. A retrospective observational study examined data from 90 COVID-19 patients who completed the follow-up period in the post-COVID clinic at the Chest Department, Kasr El Ainy Hospital, from August 2020 to August 2022. Demographic data, comorbidities, exercise tolerance, and chest computed tomography (CT) results were collected 1 and 6 months after the diagnosis. Initial CT scans (1 month following hospital admission) revealed diffuse ground-glass opacities (87.8%) and reticulations (43.3%). After 6 months, 33.3% were back to normal, 41% had persistent reticulations, 22.2% had ground glass opacities, and 3.3% had bronchiectasis. CT scores improved dramatically after 6 months. No significant link was detected between CT score change and off-label use of pirfenidone. Antifibrotic therapy has a modest effect on post-COVID lung problems. One-third of patients showed reticulations as persistent radiological abnormalities, which could guide future treatment choices.

Post-COVID-19 condition: clinical phenotypes, pathophysiological mechanisms, pathology, and management strategies.

Post-COVID-19 condition (PCC), also known as long COVID, is a complex multiple organ system condition that can develop and persist for months after acute COVID-19. PCC encompasses a wide range of symptoms, resulting in heterogeneous clinical manifestations. These manifestations likely arise from diverse underlying pathophysiological mechanisms, which, in turn, are influenced by risk factors such as age, sex, and comorbidities. To this end, characterising clinical phenotypes of PCC is essential for deepening our understanding of its (potentially) distinct pathophysiological mechanisms and for advancing diagnostic and patient-tailored management strategies. PCC is thought to result from a complex interaction of various pathophysiological mechanisms, leading to functional and structural pathological alterations across multiple organ systems. Investigating these alterations is critical to improving our currently incomplete understanding of PCC's complex pathophysiology. This review provides an overview of the main clinical phenotypes of PCC, characterises these phenotypes by examining symptoms and signs, as well as the associated risk factors. The main hypothesised pathophysiological mechanisms are discussed by outlining the current knowledge on PCC pathology, focussing on the most commonly affected organ systems. Current PCC management includes supportive care such as physiotherapy and the repurposing of existing drugs primarily targeting persistence of SARS-CoV-2 (e.g. antivirals, monoclonal antibodies) and immune dysfunction (e.g. antiinflammatory drugs, immunomodulators). To date, prevention of SARS-CoV-2 infection remains critical, which can be achieved through effective public health measures and vaccination strategies. Finally, this review highlights current knowledge gaps and proposes future research directions to advance the understanding and treatment of PCC. © 2025 The Author(s). The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Children withPost COVID-19 Multisystem InflammatorySyndrome Display Unique Pathophysiological Metabolic Phenotypes

SARS-CoV-2 infectionsin children lead to symptoms from mild respiratoryillness to severe postacute sequelae of COVID-19, including multisysteminflammatory syndrome in Children (MIS-C). We conducted a metabolicprofiling of 147 children’s serum samples, including acuteCOVID-19 patients, MIS-C patients, and healthy controls. Using nuclearmagnetic resonance spectroscopy and liquid chromatography–massspectrometry, we measured 1101 metabolites. The results revealed distinctmetabolic profiles in acute COVID-19 and MIS-C patients, with significantalterations in lipid classes. Both conditions exhibited an elevatedApo-B100/Apo-A1 ratio and increased serum inflammatory markers. MIS-Cpatients showed unique disruptions, including increased triglyceridesand altered lipoprotein composition. Despite milder clinical respiratorysymptoms, children’s metabolic disturbances mirrored thoseseen in severe adult COVID-19 patients, indicating a shared inflammatoryresponse to SARS-CoV-2. This suggests potential long-term health impacts,underscoring the need for continued research into the metabolic consequencesof COVID-19 in children.

Prevalence, Evolution and Prognostic Factors of PASC in a Cohort of Patients Discharged from a COVID Unit

Background and Aim: PASC is a potentially debilitating clinical condition consisting of different general symptoms experienced by about 10% of patients with previous SARS-CoV-2 infection. Our study analyses a cohort of patients with a history of hospitalization for COVID-19 and aims to evaluate prognostic factors for experiencing PASC and to investigate the characteristics of patients experiencing PASC symptoms. Methods: This is an observational, monocentric retrospective study including all adult patients admitted to our COVID unit from 28 February 2020 to 30 April 2022, discharged alive, and having performed at least one follow-up visit at our post-COVID outpatient clinic after a minimum of three months from discharge. Patients who experienced persistent clinical manifestations or the development of new symptoms three months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least two months with no other explanation, were defined as having PASC. Results: A total of 429 patients were discharged alive from our COVID Unit and 244 patients performed at least one follow-up visit in our outpatient clinic. Of these, 134 patients did not experience PASC, while 110 patients experienced PASC. Long-COVID patients were more frequently female (43.6% vs. 31.3%, p = 0.048), more frequently presented throat pain and headache at hospital admission (respectively 8.9% vs. 2.5%, p = 0.041 and 15.8% vs. 5%, p = 0.007), and were more likely to have a history of type 2 diabetes mellitus (25.5% vs. 13%, p =0.013). At the multivariable analysis, female gender, type 2 diabetes, and headache at admission were factors associated with PASC. All 46 patients who performed at least two different admissions in our outpatient clinic were divided in two groups: the first including the 16 patients who experienced a reduction or a resolution of symptoms related to COVID-19, the second comprising the 30 patients who experienced clinical worsening or persisting symptoms. Smoking habit was more represented among patients with stable or worsening symptoms (42.3% vs. 7.7%, p = 0.042); myalgias at admission were more frequent in the clinical worsening group (27.6% vs. 0%, p= 0.039); and a larger amount of patients who reported neuropsychiatric symptoms and respiratory symptoms were in the stable or worsening PASC symptoms group. Discussion: In conclusion, this study underscores the complexity of PASC, identifying female sex, Type 2 diabetes, and certain acute COVID-19 symptoms as potential predisposing factors for its development. PASC still represents a substantial public health challenge, and ongoing efforts are essential to better understand its underlying mechanisms and improve patient outcomes.