Risk of death
The study found that the risk of death remained significantly elevated through the 2 years in individuals who were hospitalised during the acute phase of infection. However, for non-hospitalised individuals, the increased risk of death was not significant beyond 6 months after infection.
Hospitalization risk was increased in non-hospitalised individuals during the 361–540 days following infection but not in the 541–720 days after infection. For hospitalized individuals, the risk of hospitalisation remained elevated through the entire 2-year follow-up.
Decline in risk
Over the 2-year follow-up in non-hospitalised individuals, risks declined and became not significant for 69% of the examined sequelae, but they remained increased for 31% of sequelae.
Risks of PASC related to coagulation and haematologic disorders, pulmonary disorders, fatigue, gastrointestinal disorders, musculoskeletal disorders, and diabetes remained elevated 2 years after infection in non-hospitalised individuals.
Cumulatively at 2 years after infection, PASC contributed a substantial burden in terms of disability-adjusted life years (DALYs). For non-hospitalised individuals, it was 80.4 DALYs per 1,000 persons, with 25.3% of DALYs attributed to the second year. Hospitalised individuals had a higher burden with 642.8 DALYs per 1,000 persons, of which 21.3% were from the second year.
Continued risk for hospitalised individuals
The decline in risk was less pronounced among individuals who were hospitalised during the acute phase of infection.
The study also found that the following factors were associated with an increased risk of PASC:
- Older age
- Female sex
- Black ethnicity
- Comorbidities such as diabetes, heart disease, and obesity
- Hospitalisation during the acute phase of infection
The study's findings highlight the importance of early detection and management of PASC. Individuals who experience long-term symptoms after a SARS-CoV-2 infection should seek medical attention to ensure that they receive the appropriate care.
The study underscores the long-term health effects of SARS-CoV-2 infection and highlights the substantial burden of PASC, especially for individuals who were hospitalised. While many sequelae decline over time, a significant proportion persists, emphasizing the need for ongoing care and attention to the health needs of individuals with long-term effects of COVID-19.