THURSDAY, Jan. 23, 2025 (HealthDay News) — The majority of working-age patients with postacute sequelae of COVID-19/post-COVID-19 syndrome (PCS) do not recover in the second year of their illness, according to a study published online Jan. 23 in PLOS Medicine.
Raphael S. Peter, from Ulm University in Germany, and colleagues examined clinical characteristics and diagnostic findings among patients with PCS persisting for more than one year and assessed risk factors for PCS persistence versus improvement. The analysis included data from 982 participants (aged 18 to 65 years) with PCS and 576 matched individuals without PCS at six to 12 months after acute infection (phase 1) and at another 8.5 months (phase 2).
The researchers found that at phase 2, 67.6 percent of the patients with PCS at phase 1 developed persistent PCS, while 78.5 percent of the recovered participants remained free of health problems related to PCS. Improvement was associated with mild acute index infection, previous full-time employment, educational status, no specialist consultation, and not attending a rehabilitation program, while development of new PCS symptoms among those initially recovered was associated with an intercurrent secondary severe acute respiratory syndrome coronavirus 2 infection and educational status. Patients with persistent PCS were less frequently never smokers (61.2 versus 75.7 percent), were more often obese (30.2 versus 12.4 percent), and had lower educational status (university entrance qualification, 38.7 versus 61.5 percent). The predominant symptom clusters persisted (fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness, and anxiety/depression/sleep problems). Exercise intolerance with postexertional malaise for >14 hours (35.6 percent) and symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (11.6 percent) were seen with persistent PCS.
“In the majority of patients, PCS symptoms did not improve in the second year of their illness and typically continued to include fatigue and measurable exercise intolerance and cognition deficits, but there seems to be no major pathology in laboratory investigations,” the authors write.
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