ArticleThe Lancet regional health. Europe2023
COVID-19 illness severity and 2-year prevalence of physical symptoms: an observational study in Iceland, Sweden, Norway and Denmark.
Article in The Lancet regional health. Europe, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 41 citations in OpenAlex.
- Trial
- Psychiatric genetic liability is associated with the severity of COVID-19 and other acute respiratory infections: an observational study across five Northern European countries.Genome medicine · 2026Observational
- Acute COVID-19 severity and impaired cognitive function up to 32 months after diagnosis: an observational study.BMC medicine · 2026Observational
- Long-COVID: assessment of circulating markers suggests no cerebral neuronal damage, neuroinflammation or systemic inflammation-a controlled study.Scientific reports · 2026Article
- Long-term health outcomes and risk factors for low self-rated health in non-hospitalised adults with post-COVID-19 condition: a 2.5-year cohort study.BMC public health · 2026Article
- Immunogenetic modulation of endothelial inflammation by the LIPG -384A/C promoter variant influences COVID-19 severity.Frontiers in immunology · 2026Article
- Long-term multidimensional health status of individuals with and without post COVID-19 condition: A cross-sectional study.PloS one · 2026Article
- Risk and prognosis of Omicron infection in home-based dialysis patients: a retrospective cohort study in China.BMC nephrology · 2025Observational
- SARS-CoV-2 Spike Protein Amyloid Fibrils Impair Fibrin Formation and Fibrinolysis.Biochemistry · 2025Article
- Health outcomes in hospitalised and non-hospitalised individuals after COVID-19, an observational, cross-sectional study.Communications medicine · 2025Article
- Physical activity, sedentary time, and associated factors in post-COVID-19 condition: a cross-sectional study.Journal of rehabilitation medicine · 2025Observational
- Investigating Symptom Duration Using Current Status Data: A Case Study of Postacute COVID-19 Syndrome.Epidemiology (Cambridge, Mass.) · 2025Article
- Article
- Gut Microbiome dysbiosis and immune activation correlate with somatic and neuropsychiatric symptoms in COVID-19 patients.Journal of translational medicine · 2025Article
- Article
- SARS-COV-2 re-infection and incidence of post-acute sequelae of COVID-19 (PASC) among essential workers in New York: a retrospective cohort study.Lancet regional health. Americas · 2025Article
- Long COVID and its risk factors in migrants: a nationwide register study from Sweden.BMC medicine · 2025Article
- Altered amyloid plasma profile in patients with disabling headaches after SARS-CoV-2 infection and vaccination.BMJ neurology open · 2025Article
- The overlooked burden of persistent physical symptoms: a call for action in European healthcare.The Lancet regional health. Europe · 2025Review
- A 24-month National Cohort Study examining long-term effects of COVID-19 in children and young people.Communications medicine · 2024Article
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Authors and funding
32 authors at 15 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Although the persistence of physical symptoms after SARS-CoV-2 infection is a major public health concern, evidence from large observational studies beyond one year post diagnosis remain scarce. We aimed to assess the prevalence of physical symptoms in relation to acute illness severity up to more than 2-years after diagnosis of COVID-19. Methods: This multinational study included 64,880 adult participants from Iceland, Sweden, Denmark, and Norway with self-reported data on COVID-19 and physical symptoms from April 2020 to August 2022. We compared the prevalence of 15 physical symptoms, measured by the Patient Health Questionnaire (PHQ-15), among individuals with or without a confirmed COVID-19 diagnosis, by acute illness severity, and by time since diagnosis. We additionally assessed the change in symptoms in a subset of Swedish adults with repeated measures, before and after COVID-19 diagnosis. Findings: During up to 27 months of follow-up, 34.5% participants (22,382/64,880) were diagnosed with COVID-19. Individuals who were diagnosed with COVID-19, compared to those not diagnosed, had an overall 37% higher prevalence of severe physical symptom burden (PHQ-15 score ≥15, adjusted prevalence ratio [PR] 1.37 [95% confidence interval [CI] 1.23-1.52]). The prevalence was associated with acute COVID-19 severity: individuals bedridden for seven days or longer presented with the highest prevalence (PR 2.25 [1.85-2.74]), while individuals never bedridden presented with similar prevalence as individuals not diagnosed with COVID-19 (PR 0.92 [0.68-1.24]). The prevalence was statistically significantly elevated among individuals diagnosed with COVID-19 for eight of the fifteen measured symptoms: shortness of breath, chest pain, dizziness, heart racing, headaches, low energy/fatigue, trouble sleeping, and back pain. The analysis of repeated measurements rendered similar results as the main analysis. Interpretation: These data suggest an elevated prevalence of some, but not all, physical symptoms during up to more than 2 years after diagnosis of COVID-19, particularly among individuals suffering a severe acute illness, highlighting the importance of continued monitoring and alleviation of these targeted core symptoms. Funding: This work was mainly supported by grants from NordForsk (COVIDMENT, grant number 105668 and 138929) and Horizon 2020 (CoMorMent, 847776). See Acknowledgements for further details on funding.
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