Correlates of symptomatic remission among individuals with post-COVID-19 condition

medRxiv. 2023 Feb 1;2023.01.31.23285246. doi: 10.1101/2023.01.31.23285246. Preprint


Importance: Post-COVID-19 condition (PCC), or long COVID, has become prevalent. The course of this syndrome, and likelihood of remission, has not been characterized.

Objective: To quantify the rates of remission of PCC, and the sociodemographic features associated with remission.

Design: 16 waves of a 50-state U.S. non-probability internet survey conducted between August 2020 and November 2022.

Setting: Population-based.

Participants: Survey respondents age 18 and older.

Main outcome and measure: PCC remission, defined as reporting full recovery from COVID-19 symptoms among individuals who on a prior survey wave reported experiencing continued COVID-19 symptoms beyond 2 months after the initial month of symptoms.

Results: Among 423 survey respondents reporting continued symptoms more than 2 months after acute test-confirmed COVID-19 illness, who then completed at least 1 subsequent survey, mean age was 53.7 (SD 13.6) years; 293 (69%) identified as women, and 130 (31%) as men; 9 (2%) identified as Asian, 29 (7%) as Black, 13 (3%) as Hispanic, 15 (4%) as another category including Native American or Pacific Islander, and the remaining 357 (84%) as White. Overall, 131/423 (31%) of those who completed a subsequent survey reported no longer being symptomatic. In Cox regression models, male gender, younger age, lesser impact of PCC symptoms at initial visit, and infection when the Omicron strain predominated were all statistically significantly associated with greater likelihood of remission; presence of 'brain fog' or shortness of breath were associated with lesser likelihood of remission.

Conclusions and relevance: A minority of individuals reported remission of PCC symptoms, highlighting the importance of efforts to identify treatments for this syndrome or means of preventing it.

Trial registration: N/A.

Key points: Question: How often do individuals with post-COVID-19 condition, or long COVID, recover fully, and what predicts this recovery?Findings: Among 423 individuals who initially reported post-COVID-19 condition and completed at least one subsequent survey, 131 (31%) later described symptomatic remission. Younger age, male gender, lesser symptom severity at initial survey, and infection during Omicron-predominance were associated with greater likelihood of reporting recovery.Meaning: A minority of people with post-COVID-19 condition report spontaneous remission of symptoms, highlighting the importance of developing treatments for this syndrome.

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