Ava-Kathleen D. Rybicki, MA
Clinical Research Coordinator
Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Emily L. McGinley, MS, MPH
Biostatistician
Medical College of Wisconsin
Milwaukee, Wisconsin, United States
Liliana E. E. Pezzin, PhD, JD
Professor and Econometrician
Medical College of Wisconsin
Milwaukee, Wisconsin, United States
Rachel Feuerstein-Simon, MPA, MPH
Research Manager
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Shefali Verma, PhD
Professor
Department of Pathology and Laboratory Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States
Carolyn C. Cannuscio, ScD
Associate Professor
Family Medicine and Community Health, University of Pennsylvania
Philadelphia, Pennsylvania, United States
Timothy R. Dillingham, MD, MS
Professor and Chair
Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
.jpg "Benjamin Abramoff, MD, MS photo")
Benjamin Abramoff, MD, MS
Physician
Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Quantify the incidence of severe long COVID in a large urban community sample and contrast the physical and emotional functioning of persons experiencing long COVID to those of COVID+ individuals without long COVID.
Design:
A longitudinal survey, administered to COVID+ persons at a large academic urban health system during 2020-2021, was data source. Respondents were recontacted in 2023 to ascertain their health and functioning, update their COVID history, and document persistent COVID-related symptoms.
Composite subscales of the SF-36—the physical component summary (PCS) and mental component summary (MCS) were the key outcomes. The PCS and MCS summarize the 8 dimensions measured by the SF-36, a validated instrument assessing physical functioning, mental health, bodily pain, general health, vitality, social functioning, and role limitations due to emotional problems and physical problems.
Results:
Of 15,064 individuals recontacted, 4,526 (30.0%) participated and 441 (9.7%) reported severe long-COVID defined as persistent fatigue/loss of endurance and/or cognitive deficits.
Median age of COVID+ persons who did not develop severe long-COVID was 60 years (IQR=22); 58.6% were female, and 5.2% were Black/African American. Persons with severe, persistent COVID symptoms were younger (median age= 56 years; IQR=23), and more likely to be female (71%) or identify as Black/African American (8.8%).
Persons with severe long-COVID scored significantly lower on all SF-36 subscales compared to COVID+ respondents without severe long-COVID. Specifically, the PCS mean score was 56% lower [mean(SD): 34.7(38.8) vs. 53.5(42.3), respectively] and the MCS was 35% lower then COVID+ persons without persistent symptoms [78.8(34.3) vs. 81.8(32.3), respectively].
Conclusions:
Individuals experiencing persistent fatigue and cognitive deficits following a COVID-19 infection are more likely to report poorer overall health status and increased physical and emotional limitations than COVID+ persons without severe long COVID. This highlights the need for efficacious rehabilitation programs to reduce disease burden for the large number of individuals experiencing disabling symptoms.
