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Persistent Symptoms and Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection Not Requiring Hospitalization: Results From Testing Denmark, a Danish Cross-sectional Survey

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  • Maarten van Wijhe, Roskilde University
  • ,
  • Kamille Fogh, University of Copenhagen
  • ,
  • Steen Ethelberg, Statens Serum Institut, University of Copenhagen, Denmark
  • Kasper Karmark Iversen, University of Copenhagen
  • ,
  • Henrik Nielsen, Aalborg University
  • ,
  • Lars Jørgen Østergaard
  • Berit Andersen
  • Henning Bundgaard, University of Copenhagen
  • ,
  • Charlotte S. Jørgensen, Statens Serum Institut
  • ,
  • Bibi F S S Scharff, University of Copenhagen
  • ,
  • Svend Ellermann-Eriksen
  • Isik S Johansen, University of Southern Denmark, Denmark
  • Anders Fomsgaard, Statens Serum Institut
  • ,
  • Tyra Grove Krause, Statens Serum Institut, Denmark
  • Lothar Wiese, Sjællands Universitetshospital, Denmark
  • Thea K.Fischer, University of Copenhagen
  • ,
  • Kåre Mølbak, Statens Serumsinstitut, University of Copenhagen
  • ,
  • Thomas Benfield, University of Copenhagen
  • ,
  • Fredrik Folke, University of Copenhagen, Emergency Medical Services, Denmark
  • Freddy Lippert, University of Copenhagen, Emergency Medical Services, Denmark
  • Sisse Rye Ostrowski, University of Copenhagen, Denmark
  • Anders Koch, University of Copenhagen
  • ,
  • Christian Erikstrup
  • Anne-Marie Vangsted, Statens Serum Institut
  • ,
  • Anna Irene Vedel Sørensen , Statens Serum Institut
  • ,
  • Henrik Ullum, Statens Serum Institut, Denmark
  • Robert Leo Skov, Statens Serum Institut, Denmark
  • Lone Simonsen, Roskilde University
  • ,
  • Susanne Dam Nielsen, University of Copenhagen
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with persistent symptoms ("long COVID"). We assessed the burden of long COVID among nonhospitalized adults with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection.

Methods: In the fall of 2020, a cross-sectional survey was performed in the adult Danish general population. This included a self-administered point-of-care test for SARS-CoV-2 antibodies, the Short Form Health Survey (SF-12), and coronavirus disease 2019 (COVID-19)-associated symptom questions. Nonhospitalized respondents with a positive SARS-CoV-2 PCR test ≥12 weeks before the survey (cases) were matched (1:10) to seronegative controls on age, sex, and body mass index. Propensity score-weighted odds ratios (ORs) and ORs for risk factors were estimated for each health outcome.

Results: In total, 742 cases and 7420 controls were included. The attributable risk of at least 1 long-COVID symptom was 25.0 per 100 cases (95% confidence interval [CI], 22.2-27.4). Compared to controls, cases reported worse general health (OR, 5.9 [95% CI, 5.0-7.0]) and had higher odds for a broad range of symptoms, particularly loss of taste (OR, 11.8 [95% CI, 9.5-14.6]) and smell (OR, 11.2 [95% CI, 9.1-13.9]). Physical and Mental Component Summary scores were also significantly reduced with differences of -2.5 (95% CI, -3.1 to -1.8) and -2.0 (95% CI, -2.7 to -1.2), respectively. Female sex and severity of initial infection were major risk factors for long COVID.

Conclusions: Nonhospitalized SARS-CoV-2 PCR-positive individuals had significantly reduced physical and mental health, and 1 in 4 reported persistence of at least 1 long-COVID symptom.
Original languageEnglish
Article numberofac679
JournalOpen Forum Infectious Diseases
Publication statusPublished - Jan 2023

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© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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