Prevalence, risk factors and clinical presentations of post-COVID-19 condition: a follow-up study of reported COVID-19 infections in Montreal, Canada

Background Meta-analyses suggest that post-COVID-19 condition (PCC) mostly takes three clinical presentations: fatigue, cognitive and respiratory. We sought to estimate the prevalence of these presentations and the strength of their associations with potential risk/protective factors, activity limitations and healthcare utilization. Methods Follow-up study by telephone re-interview, ≥5 months after initial interview, of a random sample of Montrealers aged 18 years or more, with a PCR-confirmed COVID-19 infection reported between July 18 and December 4, 2021. The re-interview covered age, sex, comorbidities, signs and symptoms (SS), activity limitations, healthcare utilization, perceived stigmatization and psychological distress. Results Of a sample of 2000 adults, 652 (39.1%) completed the questionnaire. Of 518 with only 1 acute episode of COVID-19, 32.2% met the WHO definition of PCC. Of these, 45.5% reported SS that fit the fatigue presentation, 24.6% the cognitive presentation and 16.8% the respiratory presentation. Neither age nor COVID-19 immunization was associated with PCC, compared to COVID-19 without PCC. However, being female (OR=2.28), hospitalization (OR=2.44) and intensive care (OR=3.21) for the acute COVID-19 episode were. Various activity limitations and types of healthcare utilization were also associated with PCC. All presentations were associated with serious psychological distress. The respiratory presentation was particularly associated with hospitalization for the acute episode (aOR=7.72) and was the only one associated with later hospitalization (aOR=23.6). Interpretation Our findings suggest that caring for patients with PCC requires adapted organizational models. If they favoured excellence in research, these models could help future studies meet the recommended methodological standards.