Long COVID symptoms before and 3-35 months after SARS-CoV-2 infection in a Norwegian prospective cohort study, symptoms over the pandemic, and different virus variants

Int J Infect Dis. 2026 Sep:170:108822. doi: 10.1016/j.ijid.2026.108822. Epub 2026 May 27.

Abstract

Objectives: Examine long COVID symptoms and prevalence of symptoms over the pandemic and compare symptoms due to the Omicron variants with symptoms due to earlier variants of the SARS-CoV-2 virus.

Methods: In the present Norwegian prospective cohort study, 11,5737 persons, aged 18-96 years, completed 1-6 questionnaires 3-35 months after a positive and/or negative SARS-CoV-2 test between 2020 and 2023.

Results: The following symptoms were reported more frequently 3-35 months after than before a positive SARS-CoV-2 test (n = 37,400): worsening of health, (odds ratio [OR] 1.79 [confidence interval (CI) 1.71-1.86]), memory problems (2.21 [2.06-2.37]), concentration problems (1.98 [1.87-2.09]), dyspnea (1.95 [1.84-2.07]), fatigue (1.46 [1.41-1.52]), and smell/taste changes (3.12 [2.84-3.42]). The prevalence of symptoms was lower at the end of 2022 than in 2020. A positive SARS-CoV-2 test during the Omicron-dominated period was associated with lower prevalence of symptoms than a positive test during the period dominated by earlier variants.

Conclusions: Several symptoms lingered up to 35 months after SARS-CoV-2 infection. The prevalence of symptoms decreased over the course of the pandemic and were reported less often in those infected with later SARS-CoV-2 variants than earlier variants. The indications of long-term persisting symptoms after COVID-19 and the consequences of new variants should be further monitored.

Keywords: Delta; Long COVID; Omicron; SARS-CoV-2; Symptoms.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • COVID-19* / virology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Pandemics
  • Post-Acute COVID-19 Syndrome
  • Prevalence
  • Prospective Studies
  • SARS-CoV-2* / genetics
  • Surveys and Questionnaires
  • Symptom Burden
  • Young Adult

Supplementary concepts

  • SARS-CoV-2 variants