Understanding the Risk Factors for Post-COVID-19 Condition

Vasiliki Tsampasian, MD, MSc

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Evidence provided by Vasiliki Tsampasian, MD, MSc, Department of Cardiology, Norfolk and Norwich University Hospital, and a team of investigators identified demographic characteristics and comorbidities that were associated with an increased risk of developing post-COVID-19 condition (PCC).¹

The data showed significant risk factors of the condition included female sex, older age, higher BMI, and smoking. Additionally, patients with conditions like anxiety, depression, asthma, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, immunosuppression, and ischemic heart disease were also found to be associated with a high risk of PCC.

The systematic review and meta-analysis also found patients who had been hospitalized or admitted to the ICU with COVID-19 were more likely to develop post-COVID-19 condition.

The Review and Meta-Analysis

Post-COVID-19 condition is a complex and heterogeneous disorder that affects millions of people worldwide. According to the study, it refers to a wide range of physical, cognitive, and mental health symptoms that persist or develop after the acute phase of COVID-19 infection.

Common PCC symptoms consist of fatigue, shortness of breath, chest pain, joint pain, memory problems, anxiety, and depression.

Given the significant impact the condition has had on the lives of individuals since the onset of the COVID-19 pandemic, investigators emphasized the importance of identifying potential risk factors in order to provide early and appropriate clinical support. In the systematic review and meta-analysis, investigators aimed to evaluate the demographic characteristics and comorbidities associated with an increased risk of developing PCC.

Data were obtained in a search of the Medline and Embase databases from their inception to December 2022 and all published studies that investigated the risk factors and predictors of PCC in adult patients aged 18 years or older were included. A total of 41 articles consisting of 860,783 patients were included in the meta-analysis.

The main outcomes and measures of the study were the risk factors for PCC: patient age, sex, BMI, smoking status, comorbidities (anxiety and/or depression, asthma, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, immunosuppression, and ischemic heart disease), previous hospitalization or ICU admission with COVID-19, and previous vaccination against COVID-19.

Demographic Risk Factors of Post-Covid-19 Condition

Investigators found several demographic characteristics and comorbidities were associated with an increased risk of developing PCC. In addition to older age, higher BMI, smoking, and being female, were found to be significant risk factors for PCC, results also indicated the presence of comorbidities like anxiety or depression, asthma, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, immunosuppression, and ischemic heart disease to be associated with a high risk of PCC.

Investigators reported patients who had been hospitalized or admitted to the ICU with COVID-19 were found to be at a higher risk of developing PCC, and when assessing previous vaccination against COVID-19, they observed a lower risk of the condition.

Furthermore, patients who had received 2 doses of a COVID-19 vaccine had a significantly lower risk of developing PCC compared with those who were not vaccinated.

According to the study, these findings could help in understanding who is at risk of developing PCC and provide additional evidence for the benefits of vaccination. Investigators noted that this information can guide healthcare providers toward targeted care to prevent or mitigate the effects of PCC.

The data also support the protective role of vaccination against PCC as a key public health intervention to reduce the burden of COVID-19-related health problems.

In conclusion, this systematic review and meta-analysis provide important insights into the risk factors for PCC.

Reference:

1. Tsampasian V, Elghazaly H, Chattopadhyay R, et al. Risk Factors Associated With Post−COVID-19 Condition: A Systematic Review and Meta-analysis. JAMA Intern Med. Published online March 23, 2023. doi:10.1001/jamainternmed.2023.0750