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Adult long-COVID patients in England reported worse mental health and related quality of life than those who were never infected or recovered from their infections, suggests a study yesterday in Nature Communications.

Imperial College London researchers analyzed self-reported mental health and quality of life among 276,840 participants from August to December 2022.

The team also used data from a follow-up survey of participants in the REal-time Assessment of Community Transmission-2 study, which included six rounds of random samples of the population to evaluate community prevalence of SARS-CoV-2 antibodies in England.

Women, those with severe infections most at risk

Overall, 59.1% of participants had tested positive for COVID-19. Symptoms among 130,251 respondents lasted for, on average, 5.4 weeks (range, 1 day to 3 years). In total, 7.5% and 5.2% reported symptoms for at least 12 weeks (long COVID) and 52 weeks or longer (very long COVID), respectively.

Risk factors for long or very long COVID included female sex (adjusted odds ratio [aOR], 1.42 and 1.49, respectively), having at least one underlying condition (aOR, 1.31 and 1.52), and moderate or severe COVID-19 (aOR, 1.76 and 1.47).

Although COVID-19 is usually of short duration, some adults experience persistent and burdensome illness, although a sizeable proportion still recover after a prolonged period.

The probability of long COVID and very long COVID was lower in Asian than in White people (aOR, 0.80 and 0.71, respectively) and in those infected during the Alpha (aOR, 0.60 and 0.59), Delta (OR, 0.38 and 0.32), or Omicron waves (OR, 0.12 for long COVID; insufficient follow-up time for very long COVID) than in those with wild-type infections.

The most common ongoing symptoms were mild fatigue (66.9%), difficulty thinking or concentrating (54.9%), and joint pain (54.6%). The greatest difference in symptom prevalence between those with ongoing symptoms and other participants were for altered smell (aOR, 9.31) or taste (aOR, 8.47), shortness of breath (aOR, 6.69), severe fatigue (aOR, 6.19), difficulty thinking or concentrating (aOR, 4.97), chest tightness or pain (aOR, 4.71), and memory loss (aOR, 4.40).

“Although COVID-19 is usually of short duration, some adults experience persistent and burdensome illness, although a sizeable proportion still recover after a prolonged period,” the authors wrote.