Prolonged Symptoms after COVID-19 in Japan: A Nationwide Survey of the Symptoms and Their Impact on Patients’ Quality of Life - 07/07/23

Doi : 10.1016/j.amjmed.2023.04.040

Hitoshi Honda, MD, PhD ^a, Akane Takamatsu, MD ^b, Toshiki Miwa, MD ^c, Takahiro Tabuchi, MD, PhD ^d, Kiyosu Taniguchi, MD, PhD ^e,^f, Kenji Shibuya, MD, DrPH ^f, Yasuharu Tokuda, MD, MPH ^f,^g,^⁎
^a Department of Infectious Diseases, Fujita Health University School of Medicine, Aichi, Japan
^b Department of Microbiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
^c Department of Infectious Diseases, The University of Tokyo Hospital, Japan
^d Cancer Control Center, Osaka International Cancer Institute, Japan
^e National Hospital Organization, Mie Medical Center, Japan
^f Tokyo Foundation for Policy Research, Japan
^g Muribushi Okinawa Center for Teaching Hospitals, Japan.

^⁎Requests for reprints should be addressed to Yasuharu Tokuda, MD, MPH, Muribushi Okinawa Center for Teaching Hospitals, Okinawa, Japan, 1-24-9 Iso, Urasoe City, 901-2132.Muribushi Okinawa Center for Teaching Hospitals1-24-9 Iso, Urasoe CityOkinawa901-2132Japan

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Abstract

Background

Clinical details of long COVID are still not well understood because of potential confounding with a wide range of pre-existing comorbidities.

Methods

The present study used datasets from a nationwide, cross-sectional, online survey. We determined which prolonged symptoms were more likely to be associated with post-COVID condition after adjusting for a wide range of comorbidities and baseline characteristics. This study also used the EuroQol 5 Dimension 5 Level (EQ-5D-5L) and Somatic Symptom Scale-8 to assess health-related quality of life (QOL) and somatic symptoms in individuals with a previous history of COVID-19, defined as the diagnosis of COVID-19 made at least 2 months prior to the online survey.

Results

In total, 19,784 respondents were included for analysis; of these, 2397 (12.1%) had a previous history of COVID-19. The absolute difference of adjusted prevalence of symptoms attributed to prolonged symptoms after COVID-19 ranged from -0.4% to +2.0%. Headache (adjusted odds ratio [aOR]: 1.22; 95% confidence interval [95% CI]:1.07-1.39), chest discomfort (aOR:1.34, 95% CI:1.01-1.77), dysgeusia (aOR: 2.05, 95% CI: 1.39-3.04), and dysosmia (aOR: 1.96, 95% CI: 1.35-2.84) were independently associated with a previous history of COVID-19. Individuals with a previous history of COVID-19 had lower health-related QOL scores.

Conclusions

After adjusting for potential comorbidities and confounders, clinical symptoms, such as headache, chest discomfort, dysgeusia, and dysosmia, were found to be independently associated with a previous history of COVID-19, which was diagnosed 2 or more months previously. These protracted symptoms might have impacted QOL and the overall somatic symptom burden in subjects with a previous history of COVID-19.

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Keywords : Long COVID, Prolonged symptoms, Quality of life, Somatic symptoms