Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia
Abstract Background Long-COVID has mostly been investigated in clinical settings. We aimed to assess the risk, subtypes, persistence, and determinants of long-COVID in a prospective population-based study of adults with a history of SARS-CoV-2 infection in Catalonia. Methods We examined 2764 infecte...
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BMC
2025-03-01
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| Online Access: | https://doi.org/10.1186/s12916-025-03974-7 |
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| author | Manolis Kogevinas Marianna Karachaliou Ana Espinosa Susana Iraola-Guzmán Gemma Castaño-Vinyals Laura Delgado-Ortiz Xavier Farré Natàlia Blay Neil Pearce Magda Bosch de Basea Eva Alonso Nogués Carlota Dobaño Gemma Moncunill Rafael de Cid Judith Garcia-Aymerich |
| author_facet | Manolis Kogevinas Marianna Karachaliou Ana Espinosa Susana Iraola-Guzmán Gemma Castaño-Vinyals Laura Delgado-Ortiz Xavier Farré Natàlia Blay Neil Pearce Magda Bosch de Basea Eva Alonso Nogués Carlota Dobaño Gemma Moncunill Rafael de Cid Judith Garcia-Aymerich |
| author_sort | Manolis Kogevinas |
| collection | DOAJ |
| description | Abstract Background Long-COVID has mostly been investigated in clinical settings. We aimed to assess the risk, subtypes, persistence, and determinants of long-COVID in a prospective population-based study of adults with a history of SARS-CoV-2 infection in Catalonia. Methods We examined 2764 infected individuals from a population-based cohort (COVICAT) established before the pandemic and followed up three times across the pandemic (2020, 2021, 2023). We assessed immunoglobulin (Ig)G levels against SARS-CoV-2, clinical, vaccination, sociodemographic, and lifestyle factors. Long-COVID risk and subtypes were defined based on participant-reported symptoms and electronic health records. We identified a total of 647 long-COVID cases and compared them with 2117 infected individuals without the condition. Results Between 2021 and 2023, 23% of infected subjects developed long-COVID symptoms. In 56% of long-COVID cases in 2021, symptoms persisted for 2 years. Long-COVID presented clinically in three subtypes, mild neuromuscular, mild respiratory, and severe multi-organ. The latter was associated with persistent long-COVID. Risk was higher among females, participants under 50 years, of low socioeconomic status, severe COVID-19 infection, elevated pre-vaccination IgG levels, obesity, and prior chronic disease, particularly asthma/chronic obstructive pulmonary disease and mental health conditions. A lower risk was associated to pre-infection vaccination, infection after omicron became the dominant variant, higher physical activity levels, and sleeping 6–8 h. Vaccination during the 3 months post-infection was also protective against long-COVID. Conclusions Long-COVID persisted for up to 2 years in half of the cases, and risk was influenced by multiple factors. |
| format | Article |
| id | doaj-art-bca50fb575824070a9f6e9d18decf584 |
| institution | DOAJ |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj-art-bca50fb575824070a9f6e9d18decf5842025-08-20T03:15:12ZengBMCBMC Medicine1741-70152025-03-0123111310.1186/s12916-025-03974-7Risk, determinants, and persistence of long-COVID in a population-based cohort study in CataloniaManolis Kogevinas0Marianna Karachaliou1Ana Espinosa2Susana Iraola-Guzmán3Gemma Castaño-Vinyals4Laura Delgado-Ortiz5Xavier Farré6Natàlia Blay7Neil Pearce8Magda Bosch de Basea9Eva Alonso Nogués10Carlota Dobaño11Gemma Moncunill12Rafael de Cid13Judith Garcia-Aymerich14ISGlobalISGlobalISGlobalGenomes for Life-GCAT Lab, CORE Program. Germans Trias I Pujol Research Institute (IGTP)ISGlobalISGlobalGenomes for Life-GCAT Lab, CORE Program. Germans Trias I Pujol Research Institute (IGTP)Genomes for Life-GCAT Lab, CORE Program. Germans Trias I Pujol Research Institute (IGTP)London School of Hygiene and Tropical MedicineISGlobalBanc de Sang I Teixits (BST)ISGlobalISGlobalGenomes for Life-GCAT Lab, CORE Program. Germans Trias I Pujol Research Institute (IGTP)ISGlobalAbstract Background Long-COVID has mostly been investigated in clinical settings. We aimed to assess the risk, subtypes, persistence, and determinants of long-COVID in a prospective population-based study of adults with a history of SARS-CoV-2 infection in Catalonia. Methods We examined 2764 infected individuals from a population-based cohort (COVICAT) established before the pandemic and followed up three times across the pandemic (2020, 2021, 2023). We assessed immunoglobulin (Ig)G levels against SARS-CoV-2, clinical, vaccination, sociodemographic, and lifestyle factors. Long-COVID risk and subtypes were defined based on participant-reported symptoms and electronic health records. We identified a total of 647 long-COVID cases and compared them with 2117 infected individuals without the condition. Results Between 2021 and 2023, 23% of infected subjects developed long-COVID symptoms. In 56% of long-COVID cases in 2021, symptoms persisted for 2 years. Long-COVID presented clinically in three subtypes, mild neuromuscular, mild respiratory, and severe multi-organ. The latter was associated with persistent long-COVID. Risk was higher among females, participants under 50 years, of low socioeconomic status, severe COVID-19 infection, elevated pre-vaccination IgG levels, obesity, and prior chronic disease, particularly asthma/chronic obstructive pulmonary disease and mental health conditions. A lower risk was associated to pre-infection vaccination, infection after omicron became the dominant variant, higher physical activity levels, and sleeping 6–8 h. Vaccination during the 3 months post-infection was also protective against long-COVID. Conclusions Long-COVID persisted for up to 2 years in half of the cases, and risk was influenced by multiple factors.https://doi.org/10.1186/s12916-025-03974-7Long-COVIDEpidemiologyCOVID-19SARS-CoV-2 antibodiesVaccinesExercise |
| spellingShingle | Manolis Kogevinas Marianna Karachaliou Ana Espinosa Susana Iraola-Guzmán Gemma Castaño-Vinyals Laura Delgado-Ortiz Xavier Farré Natàlia Blay Neil Pearce Magda Bosch de Basea Eva Alonso Nogués Carlota Dobaño Gemma Moncunill Rafael de Cid Judith Garcia-Aymerich Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia BMC Medicine Long-COVID Epidemiology COVID-19 SARS-CoV-2 antibodies Vaccines Exercise |
| title | Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia |
| title_full | Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia |
| title_fullStr | Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia |
| title_full_unstemmed | Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia |
| title_short | Risk, determinants, and persistence of long-COVID in a population-based cohort study in Catalonia |
| title_sort | risk determinants and persistence of long covid in a population based cohort study in catalonia |
| topic | Long-COVID Epidemiology COVID-19 SARS-CoV-2 antibodies Vaccines Exercise |
| url | https://doi.org/10.1186/s12916-025-03974-7 |
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