Long COVID-associated symptoms prevalent in both SARS-CoV-2 positive and negative individuals : A prospective follow-up study

Background: Research into persistent symptoms among SARS-CoV-2-positive i.e. CoV(+) patients mostly focuses on hospitalized individuals. Our prospective follow-up study compares long COVID-associated symptoms among laboratory-confirmed CoV(+) and SARS-CoV-2 negative [CoV(−)] individuals. Methods: SARS-CoV-2 RT-PCR-tested volunteers were recruited into four cohorts: 1) CoV(+) outpatients, 2) CoV(−) outpatients, 3) CoV(+) intensive care unit (ICU) inpatients, and 4) CoV(+) non-ICU inpatients. Neutralizing antibodies were assessed and questionnaires filled in at enrolment and days 90–120, 121–180, 181–270, 271–365, and 365–533. Results: Of the 1326 participants, 1191 were CoV(+): 46 ICU, 123 non-ICU, and 1022 outpatients; 135 were CoV(−) outpatient controls. Both CoV(+) outpatients and CoV(−) controls showed high overall symptom rates at all time points. More prevalent among CoV(+) than CoV(−) outpatients were only impaired olfaction and taste; many others proved more frequent for CoV(−) participants. At ≥181 days, fatigue, dyspnoea, various neuropsychological symptoms and several others were recorded more often for CoV(+) inpatients than outpatients. Conclusions: Long COVID-associated symptoms were more frequent among hospitalized than non-hospitalized CoV(+) participants. As for outpatients, only impaired olfaction and taste showed higher rates in the CoV(+) group; some symptoms proved even more common among those CoV(−). Besides suggesting low long COVID prevalences for outpatients, our results highlight the weight of negative controls.