Complications Post-COVID-19 and Risk Factors among Patients after Six Months of a SARS-CoV-2 Infection: A Population-Based Prospective Cohort Study

Abstract

In October 2020, we conducted a population-based prospective cohort study to determine post-COVID-19 complications, recovery, return to usual health, and associated risk factors in 536 cases of COVID-19 outbreak in Borriana (Spain) by administering an epidemiological questionnaire via phone interviews. A total of 484 patients participated (90.3%), age mean 37.2 ± 17.1 years, and 301 females (62.2%). Mild illness was the most common COVID-19 manifestation. After six months, 160 patients (33.1%) suffered at least one complication post-COVID-19, and 47 (29.4%) of them sought medical assistance. The most frequent persistent symptoms were hair loss, fatigue, loss of smell or taste, and headache. Risk factors associated with a complication were female sex (adjusted relative risk, [aRR] = 1.93 95% confidence interval [CI] 1.41–2.65), age 35 years and above (aRR = 1.50 95% CI 1.14–1.99), B blood group (aRR = 1.51 95% CI 1.04–2.16), current smoker (RR = 1.61 95% CI 1.02–2.54), and at least a COVID-19 exposure (aRR = 2.13 95% CI 1.11–4.09). Male sex, age younger than 35 years, and low COVID-19 exposures were associated with better recovery and return to usual health. A third of patients presented persistent symptoms compatible with the long-COVID-19 syndrome. In conclusion, an active medical follow-up of post-COVID-19 patients must be implemented.