Recovery from post-COVID-19 condition and associated factors: the PRIME post-COVID study

BackgroundDespite the high number of post-COVID-19 condition (PCC) cases worldwide, little is known about recovery and its associated factors yet. This study aimed to estimate the proportion of PCC patients that recover, and identity environment and individual factors. MethodsLongitudinal data of the PRIME cohort were analysed in patients with past infection who felt unrecovered at baseline (November 2021), grouped based on capacity of daily functioning (i.e., moderate to severe problems (PCC-impairedDA) or no or slight problems (PCC-affectedDA)). Proportions of recovery or deterioration at follow-up (after 9 months) were calculated. A range of individual, interpersonal, social network, and social and physical environment factors were assessed for lower likelihood for recovery, using multivariable logistic regression. Findings879 patients were analysed. Of patients with PCC-affectedDA (n=602), 222 (36.9%) recovered and 59 (9.8%) deteriorated to PCC-impairedDA. Of patients with PCC-impairedDA (n=277), 30 (10.8%) recovered and 88 (31.8%) improved in daily functioning; recovery was 2.1% when acute illness was >12 months before baseline, and was 12.5% and 13.6% when acute illness was 6-12 and 3-6 months before baseline, respectively. In both PCC groups, individual and environment factors that lowered recovery likelihood included worse physical health (mild/severe fatigue, severe dyspnea, severe symptoms of amnesia, concentration difficulties, muscle pain or -weakness, loss/change of smell/taste), worse mobility (hours spend lying down, problems with walking), worse mental health (depression), worse acute illness (more symptoms, hospitalization/oxygen use), former smoking, living in a rural area, having a relationship, and having more practical social network supporters (in patients with chronic co-morbidities). InterpretationOnly 11%-37% of PCC patients recovered after 9 months, leaving significant room for improvement. Future research should identify modifiable factors and treatments to help assist the recovery of PCC patients. FundingThis study was funded by the Dutch National Institute for Health and Environment, Ministry of Health, Welfare and Sport (Grant numbers: 3910090442/3910105642/3910121041).