Post-COVID-19 condition in prospective inpatient and outpatient cohorts, 2025, Hurme et al

Post-COVID-19 condition in prospective inpatient and outpatient cohorts

Antti Hurme, Arja Viinanen, Johanna Teräsjärvi, Pinja Jalkanen, Thijs Feuth, Eliisa Löyttyniemi, Tytti Vuorinen, Anu Kantele, Jarmo Oksi, Qiushui He, Ilkka Julkunen

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Abstract
Viral persistence, immune dysregulation, hypocortisolism, and pulmonary tissue damage from acute infection are proposed as pathogenic mechanisms underlying post-COVID-19 condition (PCC).

In this prospective observational study, we followed 62 COVID-19 inpatients and 53 COVID-19 outpatients for 24 months after the infection. During this period, we assessed prolonged symptoms, lung function, and a set of immunological markers and a proportion of the patient group was assessed with computed tomography three months post-infection.

The prevalence of PCC, as assessed by four medical specialists, decreased from 51% at three months to 18% at 24 months. Risk factors included the severity of the acute infection and comorbidities of obstructive sleep apnea or obesity. Patients with PCC had higher serum levels of anti-SARS-CoV-2 S1 and N protein antibodies.

In the whole group, spirometry results, orthostatic hypotension, or levels of soluble suppression of tumorigenicity 2, interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), or cortisol had no association with PCC. However, using symptom clusters, patients with cognitive problems had lower cortisol levels, while patients with ongoing respiratory or myalgic symptoms had higher levels of IL-6 and hs-CRP. However, more extensive studies with clustering are needed to validate these results.

Link | PDF (Scientific Reports) [Open Access]

 

A study to keep in mind about recovery rates within the first couple years. Though note the somewhat high proportion of participants lost to follow-up.

 

If you exclude baseline to 3 months, most of those lost were nPCC.

Do they show numbers for recovery rate in terms of how many that moved from the PCC to nPCC?

 

I don't think so, and I was trying to calculate it from this chart, but I think there's a mistake. I added the two arrows.

At 6 months there are 8 PCC. It looks like fewer participants (looks like 1) leave the PCC group than join the group (looks like 2 lost to follow-up at 6 months came back) by 12 months, yet it goes down to 7 PCC.

 

You’re right. The graph doesn’t match tve labels.

 

I'll see if I can send them an email to inquire. The two that returned might not be included in the 12 month or 24 month prevalence.

 

They didn't respond, but I'm pretty sure it's just the width of the one line going from PCC to nPCC got messed up in the chart and should be wider to represent 3 participants. A value of 3 there also makes the change in nPCC from 6 months to 12 months make sense. (Starts at 31, ends up at 30. 4 are lost to followup, so 3 must be added for the math to work out.)



Also a couple of the other plots have 11 dots at 24 months, which matches the reported prevalences.