ArticleBMC geriatrics2026
Strict long COVID, symptom persistence, and functional decline among community-dwelling older adults in Quito, Ecuador: a cross-sectional study.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLong COVID is an increasingly recognized health concern in older adults, yet data from Latin America remain limited. Older adults may be particularly vulnerable to post-COVID sequelae because of frailty, multimorbidity, and reduced physiological reserve. This study aimed to estimate the prevalence of strict long COVID among older Ecuadorian adults and to characterize persistent post-COVID symptoms, clinical correlates, and functional/cognitive worsening.
methodsWe conducted a cross-sectional study of 1,050 community-dwelling adults aged 65 years or older with PCR-confirmed SARS-CoV-2 infection in Quito, Ecuador. Data were collected through structured face-to-face interviews and cognitive screening. Strict long COVID was defined as symptoms persisting for more than 12 weeks after SARS-CoV-2 infection. Symptoms lasting 4-12 weeks were classified as persistent post-COVID symptoms but were not considered strict long COVID. Multivariable logistic regression was used to evaluate factors associated with strict long COVID.
resultsThe mean age was 74.2 ± 7.5 years, and 565 participants (53.8%) were women. Overall, 191 participants met criteria for strict long COVID, corresponding to a prevalence of 18.2% (95% CI, 16.0-20.6). Persistent post-COVID symptoms lasting 4-6 weeks and 7-12 weeks were reported by 401 (38.2%) and 458 (43.6%) participants, respectively. Participants with strict long COVID had higher frequencies of dyspnea, cognitive impairment, sleep disturbance, myalgia, depression, anxiety, and difficulty sleeping. Functional/cognitive worsening was more frequent among participants with strict long COVID than among those without strict long COVID (53.4% vs. 36.6%; p < 0.001), particularly for walking or climbing stairs. In multivariable analysis, severe or critical acute COVID-19 was independently associated with strict long COVID (adjusted OR, 2.36; 95% CI, 1.62-3.41; p < 0.001). Female sex, age ≥ 81 years, incomplete vaccination, diabetes with organ involvement, hospitalization, and care dependence were not independently associated with strict long COVID.
conclusionStrict long COVID affected nearly one in five older adults with PCR-confirmed SARS-CoV-2 infection in Quito, Ecuador. Severe or critical acute COVID-19 was the main factor independently associated with strict long COVID, and affected participants had greater functional/cognitive worsening. These findings support integrating post-COVID screening, functional assessment, and geriatric rehabilitation into primary care for older adults in Latin America.
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