About the project
The assessments include comprehensive symptom scores, deep immune cell phenotyping, blood transcriptomics, neurocognitive tests and functional brain MRI.
The project entails comprehensive prediction analyses as well as cross-sectional assessments across groups of post-COVID-19 condition sufferers, recovered patients and healthy controls.
Background
Long COVID, or post-COVID-19 condition, is an emerging global health concern, characterised by prolonged symptoms and disability after infection with the Sars acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
The underlying causal mechanisms remain unresolved, in particular among the large number of young people who experienced mild acute COVID-19.
Objectives
The LoTECA project aimed to investigate a broad range of potential risk factors and mechanisms for development of persistent symptoms after COVID-19.
Method
A prospective cohort of SARS-CoV-2-positive individuals aged 12-25 years and comparable SARS-CoV-2-negative individuals was enrolled during the early convalescent stage (baseline) and followed for six months (n=517).
Participants underwent pulmonary, cardiac and cognitive functional testing, a clinical examination, immunological and organ injury biomarker analyses, and completion of a questionnaire.
The main outcome was long COVID, and participants were classified according to the World Health Organisation clinical case definition.
A total of 404 SARS-CoV-2-positive and 105 SARS-CoV-2-negative individuals were enrolled; 26 were lost to follow-up, and 16 were excluded due to SARS-CoV-2 infection during the observational period.
The point prevalence of long COVID at six months was 49 % in the SARS-CoV-2-positive group and 47 % in the SARS-CoV-2-negative group (risk difference 1.5, 95 % CI -1.0 to 1.3).
Outcomes
A main finding from the project is that SARS-CoV-2-positivity in itself was poorly associated with development of long COVID in young people.
Rather, the main baseline predictor for persistent symptoms was self-reported symptom severity, which correlated strongly to personality traits, as well as low physical activity and loneliness.
Hence, the findings suggest that in adolescents and young adults with mild acute COVID-19, persistent symptoms and disability were not driven by the infection, but were associated with psychosocial factors.
Other important findings from LoTECA include:
- Post-COVID-19 condition is poorly associated with immunological markers in blood
- Post-COVID-19 condition is characterized by subjective cognitive complaints, but normal cognitive function tests and brain injury biomarker levels.
Data analyses are ongoing, and more results will be published in 2024.
Cooperation
- Professor Trygve Holmøy, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
- Associate Professor Gunnar Einvik, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
- Associate Professor Truls Michael Leegaard, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
- Adjunct Professor Tom Eirik Mollnes, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo
- Senior physician/doctor Fridtjof Lund-Johansen, Oslo University Hospital
- The COFFI collaborative (external page)