Over half of survey respondents in East England who had COVID-19 in 2020 reported persistent long-COVID symptoms and continued use of health services in early 2021, with a disproportionate burden among overweight women.
The findings were published yesterday in PLOS Global Public Health by a team led by Norwich Medical School researchers at the University of East Anglia. The researchers examined primary care records, and in February of 2021 sent an online survey on lingering symptoms and healthcare use to Norfolk residents infected with the virus by Dec 6, 2020, before COVID-19 vaccines were widely available. The average participant age was 50 years, and 61% were women.
Of 1,487 survey respondents, 52.1% reported long-COVID symptoms. Incidence was 55.9% in women and 46.0% in men. Male sex was protective (relative risk [RR], 0.748), while higher body mass index (BMI) was tied to greater risk (RR, 1.031 per 1 kilogram per meter squared [kg/m2]). “Based on the above, it can be estimated that for a man to have the same probability as female of same age with normal BMI they have to have a BMI over 35 kg/m2,” indicating obesity, the researchers wrote.
Age per 1-year increase was not an independent risk factor for lingering symptoms (RR, 1.003).
A total of 25.4% participants used more health services after they recovered from their initial infections, of whom 73.2% reported long-COVID symptoms. Long-COVID patients had significantly higher odds of seeking further health services than those without persistent symptoms (RR, 3.28).
Relative to women, men were much less likely to use further health services (RR, 0.750). Male sex was negatively associated with continued use of health services (RR, 0.618), while BMI was positively linked (RR, 1.027).
In a University of East Anglia news release, senior author Vassilios Vassiliou, MBBS, PhD, said the findings can be used to identify patients at risk for long COVID. “We hope that our work will help policymakers plan local services and also inform the wider public of the scale of the long Covid pandemic,” he added.