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  • Subramanian, Anuradhaa; Nirantharakumar, Krishnarajah; Hughes, Sarah; Myles, Puja; Williams, Tim; Gokhale, Krishna M; Taverner, Tom; Chandan, Joht Singh; Brown, Kirsty; Simms-Williams, Nikita; Shah, Anoop D; Singh, Megha; Kidy, Farah; Okoth, Kelvin; Hotham, Richard; Bashir, Nasir; Cockburn, Neil; Lee, Siang Ing; Turner, Grace M; Gkoutos, Georgios V; Aiyegbusi, Olalekan Lee; McMullan, Christel; Denniston, Alastair K; Sapey, Elizabeth; Lord, Janet M; Wraith, David C; Leggett, Edward; Iles, Clare; Marshall, Tom; Price, Malcolm J; Marwaha, Steven; Davies, Elin Haf; Jackson, Louise J; Matthews, Karen L; Camaradou, Jenny; Calvert, Melanie; Haroon, Shamil

    Nature medicine, 08/2022, Volume: 28, Issue: 8
    Journal Article

    Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is associated with a range of persistent symptoms impacting everyday functioning, known as post-COVID-19 condition or long COVID. We undertook a retrospective matched cohort study using a UK-based primary care database, Clinical Practice Research Datalink Aurum, to determine symptoms that are associated with confirmed SARS-CoV-2 infection beyond 12 weeks in non-hospitalized adults and the risk factors associated with developing persistent symptoms. We selected 486,149 adults with confirmed SARS-CoV-2 infection and 1,944,580 propensity score-matched adults with no recorded evidence of SARS-CoV-2 infection. Outcomes included 115 individual symptoms, as well as long COVID, defined as a composite outcome of 33 symptoms by the World Health Organization clinical case definition. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for the outcomes. A total of 62 symptoms were significantly associated with SARS-CoV-2 infection after 12 weeks. The largest aHRs were for anosmia (aHR 6.49, 95% CI 5.02-8.39), hair loss (3.99, 3.63-4.39), sneezing (2.77, 1.40-5.50), ejaculation difficulty (2.63, 1.61-4.28) and reduced libido (2.36, 1.61-3.47). Among the cohort of patients infected with SARS-CoV-2, risk factors for long COVID included female sex, belonging to an ethnic minority, socioeconomic deprivation, smoking, obesity and a wide range of comorbidities. The risk of developing long COVID was also found to be increased along a gradient of decreasing age. SARS-CoV-2 infection is associated with a plethora of symptoms that are associated with a range of sociodemographic and clinical risk factors.