Risk factors and clinical presentations of long COVID: a retrospective observational propensity score matching study

Lanre Peter Daodu; Yogini Raste; Francesca I.F. Arrigoni; Judith E. Allgrove; Reem Kayyali

doi:10.1101/2025.03.01.25323136

Risk factors and clinical presentations of long COVID: a retrospective observational propensity score matching study

Lanre Peter Daodu
, Yogini Raste
, Francesca I.F. Arrigoni
, Judith E. Allgrove
, Reem Kayyali

Croydon Health Services NHS Trust

Research output: Working paper › Preprint

Abstract

Introduction

Long COVID symptoms can affect multiple body systems and result in complicated clinical presentations. Research on long COVID is fraught with various challenges, particularly identifying risk factors, understanding pathophysiology, and implementing effective management strategies. This study assessed long COVID risk factors and evaluated the symptoms presented by affected individuals.

Methods

We conducted a hospital-based single-centre retrospective study of 627 adult patients managed for COVID-19. The patients were divided into long COVID and non-long COVID cohorts. We employed propensity score matching (PSM) to create matched groups of participants based on their predicted risk of long COVID and subsequently calculated the multiplicative effects on the odds of developing it. The prevalence of each clinical symptom was calculated as a percentage to determine the most common.

Results

The study included 627 COVID-19 patients, with an average age of 59 (±20) years. The cohort included 375 without and 252 with long COVID. Each additional year of age increased the odds of long COVID by 6.4% (OR 1.06, p=0.00). BMI (OR 1.03, p=0.04), Asian or Asian British (OR 2.64, p = 0.03), and former smokers (OR 6.44, p=0.05) had significantly higher odds of long COVID. Long COVID risk rose with the number of comorbidities. Interstitial lung diseases (ILDs) (OR 2.93, p=0.02), high Clauss fibrinogen level (OR 1.22, p=0.00), and serum Sodium (Na+) (OR 1.07, p = 0.02) significantly increased the odds of long COVID. The most prevalent clinical presentations were fatigue (81%), shortness of breath (61%) and dry cough (19%).

Conclusions

The study identified key risk factors for long COVID, including age, BMI, ethnicity, former smoking habits, comorbidities, and ILDs. Clauss fibrinogen and serum Na+ were also significant biomarkers. The main symptoms were fatigue, shortness of breath, and dry cough. The multifaceted effects of long COVID necessitate a multidisciplinary approach to patient care.

Original language	English
Publisher	medRxiv
Number of pages	48
DOIs	https://doi.org/10.1101/2025.03.01.25323136
Publication status	Published - 5 Mar 2025

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10.1101/2025.03.01.25323136Licence: CC BY-NC-ND

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title = "Risk factors and clinical presentations of long COVID: a retrospective observational propensity score matching study",

abstract = "Introduction Long COVID symptoms can affect multiple body systems and result in complicated clinical presentations. Research on long COVID is fraught with various challenges, particularly identifying risk factors, understanding pathophysiology, and implementing effective management strategies. This study assessed long COVID risk factors and evaluated the symptoms presented by affected individuals. Methods We conducted a hospital-based single-centre retrospective study of 627 adult patients managed for COVID-19. The patients were divided into long COVID and non-long COVID cohorts. We employed propensity score matching (PSM) to create matched groups of participants based on their predicted risk of long COVID and subsequently calculated the multiplicative effects on the odds of developing it. The prevalence of each clinical symptom was calculated as a percentage to determine the most common. Results The study included 627 COVID-19 patients, with an average age of 59 (±20) years. The cohort included 375 without and 252 with long COVID. Each additional year of age increased the odds of long COVID by 6.4\% (OR 1.06, p=0.00). BMI (OR 1.03, p=0.04), Asian or Asian British (OR 2.64, p = 0.03), and former smokers (OR 6.44, p=0.05) had significantly higher odds of long COVID. Long COVID risk rose with the number of comorbidities. Interstitial lung diseases (ILDs) (OR 2.93, p=0.02), high Clauss fibrinogen level (OR 1.22, p=0.00), and serum Sodium (Na+) (OR 1.07, p = 0.02) significantly increased the odds of long COVID. The most prevalent clinical presentations were fatigue (81\%), shortness of breath (61\%) and dry cough (19\%). Conclusions The study identified key risk factors for long COVID, including age, BMI, ethnicity, former smoking habits, comorbidities, and ILDs. Clauss fibrinogen and serum Na+ were also significant biomarkers. The main symptoms were fatigue, shortness of breath, and dry cough. The multifaceted effects of long COVID necessitate a multidisciplinary approach to patient care.",

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AU - Daodu, Lanre Peter

AU - Raste, Yogini

AU - Arrigoni, Francesca I.F.

AU - Allgrove, Judith E.

AU - Kayyali, Reem

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N2 - Introduction Long COVID symptoms can affect multiple body systems and result in complicated clinical presentations. Research on long COVID is fraught with various challenges, particularly identifying risk factors, understanding pathophysiology, and implementing effective management strategies. This study assessed long COVID risk factors and evaluated the symptoms presented by affected individuals. Methods We conducted a hospital-based single-centre retrospective study of 627 adult patients managed for COVID-19. The patients were divided into long COVID and non-long COVID cohorts. We employed propensity score matching (PSM) to create matched groups of participants based on their predicted risk of long COVID and subsequently calculated the multiplicative effects on the odds of developing it. The prevalence of each clinical symptom was calculated as a percentage to determine the most common. Results The study included 627 COVID-19 patients, with an average age of 59 (±20) years. The cohort included 375 without and 252 with long COVID. Each additional year of age increased the odds of long COVID by 6.4% (OR 1.06, p=0.00). BMI (OR 1.03, p=0.04), Asian or Asian British (OR 2.64, p = 0.03), and former smokers (OR 6.44, p=0.05) had significantly higher odds of long COVID. Long COVID risk rose with the number of comorbidities. Interstitial lung diseases (ILDs) (OR 2.93, p=0.02), high Clauss fibrinogen level (OR 1.22, p=0.00), and serum Sodium (Na+) (OR 1.07, p = 0.02) significantly increased the odds of long COVID. The most prevalent clinical presentations were fatigue (81%), shortness of breath (61%) and dry cough (19%). Conclusions The study identified key risk factors for long COVID, including age, BMI, ethnicity, former smoking habits, comorbidities, and ILDs. Clauss fibrinogen and serum Na+ were also significant biomarkers. The main symptoms were fatigue, shortness of breath, and dry cough. The multifaceted effects of long COVID necessitate a multidisciplinary approach to patient care.

AB - Introduction Long COVID symptoms can affect multiple body systems and result in complicated clinical presentations. Research on long COVID is fraught with various challenges, particularly identifying risk factors, understanding pathophysiology, and implementing effective management strategies. This study assessed long COVID risk factors and evaluated the symptoms presented by affected individuals. Methods We conducted a hospital-based single-centre retrospective study of 627 adult patients managed for COVID-19. The patients were divided into long COVID and non-long COVID cohorts. We employed propensity score matching (PSM) to create matched groups of participants based on their predicted risk of long COVID and subsequently calculated the multiplicative effects on the odds of developing it. The prevalence of each clinical symptom was calculated as a percentage to determine the most common. Results The study included 627 COVID-19 patients, with an average age of 59 (±20) years. The cohort included 375 without and 252 with long COVID. Each additional year of age increased the odds of long COVID by 6.4% (OR 1.06, p=0.00). BMI (OR 1.03, p=0.04), Asian or Asian British (OR 2.64, p = 0.03), and former smokers (OR 6.44, p=0.05) had significantly higher odds of long COVID. Long COVID risk rose with the number of comorbidities. Interstitial lung diseases (ILDs) (OR 2.93, p=0.02), high Clauss fibrinogen level (OR 1.22, p=0.00), and serum Sodium (Na+) (OR 1.07, p = 0.02) significantly increased the odds of long COVID. The most prevalent clinical presentations were fatigue (81%), shortness of breath (61%) and dry cough (19%). Conclusions The study identified key risk factors for long COVID, including age, BMI, ethnicity, former smoking habits, comorbidities, and ILDs. Clauss fibrinogen and serum Na+ were also significant biomarkers. The main symptoms were fatigue, shortness of breath, and dry cough. The multifaceted effects of long COVID necessitate a multidisciplinary approach to patient care.

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DO - 10.1101/2025.03.01.25323136

M3 - Preprint

BT - Risk factors and clinical presentations of long COVID

PB - medRxiv

ER -

Risk factors and clinical presentations of long COVID: a retrospective observational propensity score matching study

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