Long Covid prevalence and risk factors in adults residing in middle- and high-income countries
Secondary analysis of the multinational Anti-Coronavirus Therapies (ACT) trials
Bibliographic Data
| ID | 21880382 |
|---|---|
| Authors | Lucas E Hermans (0000-0002-8741-5852, Groote Schuur Hospital), Sean Wasserman (0000-0002-3508-6719, St George's, University of London), Lizhen Xu (0009-0007-0110-023X, Population Health Research Institute), John Eikelboom (Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada), John W Eikelboom (0000-0003-4126-1285, McMaster University) |
| Year | 2025 |
| Volume | 10 |
| Issue | 4 |
| Pages | e017126 |
| Publication date | 2025-04-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2024-017126 |
| PMID | 40234052 |
| OpenAlex | W4409472174 |
| Language | EN |
| Citations received | 1 |
| References cited | 26 |
BACKGROUND: During the recent COVID-19 pandemic, reports of long-term persistence or recurrence of symptoms after SARS-CoV-2 infection emerged, which are now collectively referred to as 'long COVID'. Most descriptions of long COVID originate from patients residing in high-income countries. We set out to characterise long COVID in a large-scale clinical trial that was conducted in low-middle, high-middle and high-income countries. METHODS: The Anti-Coronavirus Therapies trials enrolled 6528 adult patients with symptomatic COVID-19 in Argentina, Brazil, Canada, Colombia, Ecuador, Egypt, India, Nepal, Pakistan, Philippines, Russia, Saudi Arabia, South Africa and the United Arab Emirates. Long COVID was defined as the presence of patient-reported symptoms at 180 days after enrolment. Multivariable logistic regression was used to evaluate associations of baseline characteristics with long COVID. RESULTS: Of 4697 included participants, 1181 (25.1%) reported long COVID symptoms. The most frequently reported symptoms were sleeping disorders (n=601; 12.8%), joint pain (n=461; 9.8%), fatigue (n=410; 8.7%) and headaches (n=382; 8.1%). Long COVID prevalence was higher in participants from lower middle-income compared with high-income countries (29.8% (850/2854) vs 14.4% (102/706); adjusted OR (aOR) 1.53 (1.10 to 2.14); p=0.012). Prevalence also varied between participants of different ethnic backgrounds and was highest (36.1% (775/2145)) for patients of Arab/North African ethnicity. Patients requiring inpatient admission were at increased risk of long COVID (aOR: 2.04 (1.63 to 2.54); p<0.001). Other independent predictors of long COVID were male sex, older age and hypertension. Vaccination, prior lung disease, smoking and diabetes mellitus conferred protective effects. CONCLUSION: Symptoms of long COVID are reported in a quarter of cases of symptomatic COVID-19 in this study and were significantly more prevalent in participants from countries with lower income status and in patients of Arab/North African ethnicity. Research to further assess the health burden posed by long COVID in low- and middle-income countries is urgently needed
Disease · Ethnic group · Logistic regression · Pandemic · Public health · Young adult · Chronic Obstructive Pulmonary Disease (COPD) Research · Demography · Fibromyalgia and Chronic Fatigue Syndrome Research · Long-Term Effects of COVID-19 · Medicine · Epidemiology · Internal Medicine
| Citations per year | 1 |
|---|---|
| Citation span | 2026 - 2026 (1) |
| Highly cited | No |