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                  <biblScope unit="volume">17</biblScope>
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                  <date type="datePub">2022-06</date>
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                <term xml:lang="en">Long-covid</term>
                <term xml:lang="en">Post-infectious symptoms</term>
                <term xml:lang="en">Persistent symptoms</term>
                <term xml:lang="en">Populationbased study</term>
                <term xml:lang="en">Constances</term>
                <term xml:lang="en">Post-covid condition</term>
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              <p>BackgroundMany patients report persistent symptoms after COVID-19. Our aim was to determine whether some of these symptoms were more associated with past SARS-CoV-2 infection compared to other conditions.MethodsThis prospective survey was nested in CONSTANCES, a randomly selected French population-based cohort, started in 2012. All participants being followed-up by internet completed 2 questionnaires during the first wave of the pandemic focusing on the acute symptoms of their COVID-19-like illness. Serological tests for SARS-CoV-2 were then performed (May-Nov 2020). Between December 2020 and January 2021, participants completed a third questionnaire about symptoms that had lasted more than 2 months. Participants were classified into four groups according to both European Center for Diseases Control (ECDC) criteria for COVID-19 (ECDC+ or ECDC-) and serological SARS-CoV-2 test results (Sero+ or Sero-). To compare the risk of each persistent symptom among the groups, logistic regression models were adjusted for age, sex, educational level, comorbidities, and the number of acute symptoms declared during the first wave of the epidemic. A mediation analysis was performed to estimate the direct effect of the infection on persistent symptoms and its indirect effect via the initial clinical presentation.FindingsThe analysis was performed in 25,910 participants. There was a higher risk of persistent dysgeusia/anosmia, dyspnea and asthenia in the ECDC+/Sero+ group than in the ECDC+/Sero- group (OR: 6.83 [4.47–10.42], 1.69 [1.07–2.6] and 1.48 [1.05–2.07], respectively). Abdominal pain, sensory symptoms or sleep disorders were at lower risk in the ECDC+/Sero+ group than in the ECDC+/Sero- group (0.51 [0.24–0.96], 0.40 [0.16–0.85], and 0.69 [0.49–0.95], respectively). The mediation analysis revealed that the association of the serological test results with each symptom was mainly mediated by ECDC symptoms (proportion mediated range 50–107%).ConclusionA greater risk of persistent dysgeusia/anosmia, dyspnea and asthenia was observed in SARS-CoV-2 infected people. The initial clinical presentation substantially drives the association of positive serological test results with persistent symptoms.</p>
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          <desc>La cohorte CONSTANCES - Infrastructure épidémiologique ouverte pour la recherche et la surveillance</desc>
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          <desc>Santé, perception, pratiques, relations et inégalités sociales en population générale pendant la crise COVID-19 - Sérologie</desc>
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