ArticleBMC infectious diseases2025
Long COVID-19: a Four-Year prospective cohort study of risk factors, recovery, and quality of life.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Four-Year Longitudinal Phenotyping of Post-Acute Sequelae of SARS-CoV-2 Infection (PASC): A Single-Centre Cohort Study.Journal of clinical medicine · 2026Article
- Determinants and Consequences of Long Impact of COVID-19: A National Cross-Sectional Study in Saudi Arabia.Journal of clinical medicine · 2026Article
- A Descriptive Pilot Assessment of Simple Outpatient Functional Measures Following SARS-CoV-2 Infection in Adults with Chronic Diseases.Healthcare (Basel, Switzerland) · 2026Article
- Implementation of an interdisciplinary research model at a tertiary University Hospital in São Paulo, Brazil: post-COVID-19 cohort study.Clinics (Sao Paulo, Brazil) · 2026Article
- Prevalence, symptoms, and associated factors of long COVID: a retrospective cohort study based on data from two major German health authorities.BMC infectious diseases · 2026Article
- Pulmonary sequelae of SARS-CoV-2 infection: a narrative review of long-term functional, radiological, and clinical outcomes in COVID-19 survivors, with a regional focus on Saudi Arabia.Frontiers in physiology · 2026Review
- Long COVID Prevalence and Risk Factors: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.Biomedicines · 2025Review
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8 authors.
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Abstract
purposeLong COVID-19 is a growing public health concern, but its long-term burden and predictors remain underexplored, particularly in underrepresented populations.
methodsThis four-year prospective cohort study was conducted in Saudi Arabia, enrolling adults with confirmed acute COVID-19 from multiple affiliated healthcare centers between March 2020 and March 2024. Of 1,521 screened patients, 816 were enrolled and followed for up to four years (median: 24 months). Per WHO criteria, participants were classified as having long COVID-19 (n = 238) or resolved infection (n = 578). Demographics, comorbidities, vaccination, reinfection, and acute illness severity were recorded. Health-related quality of life (HRQoL) was assessed using SF-36 and EQ-5D-5 L. Logistic regression identified predictors of long COVID-19, and Cox proportional hazards models evaluated time to recovery.
resultsFatigue (57.1%), post-exertional malaise (45.8%), cough (41.2%), and cognitive dysfunction (30.7%) were the most common persistent symptoms. Female sex (adjusted OR 11.11; 95% CI: 4.48–26.24) and diabetes mellitus (adjusted OR 14.3; 95% CI: 7.0–29.4) independently predicted long COVID-19. Delayed recovery was associated with female sex (aHR 3.36; 95% CI: 1.85–6.10), diabetes (aHR 1.57; 95% CI: 1.00–2.46), reinfection (aHR 1.86; 95% CI: 1.05–3.29), and hospitalization (aHR 1.08; 95% CI: 1.01–1.16). HRQoL scores remained significantly lower at 6 and 12 months. In the long COVID-19 group, 38.7% of patients normally resumed work within 12 months, compared to 82.3% in the resolved COVID-19 group.
conclusionsNearly 29% of post-acute COVID-19 patients developed long COVID-19 in this Middle Eastern cohort. Female sex, diabetes, reinfection, and hospitalization predicted delayed recovery. Persistent symptoms and impaired HRQoL highlight the need for early risk stratification and structured post-COVID care.
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