223 - Demographics, comorbidities, and symptoms in Veterans with Long COVID

Objectives: The goal of this analysis is to describe characteristics and symptoms of Long COVID patients in an urban Veterans Affairs hospital and identify whether changes in the predominant variant affect these variables.

Design: This is a retrospective quality improvement analysis of patients evaluated in a Post-COVID-19 Interdisciplinary Rehabilitation Clinic (“Long COVID Clinic”). Information collected included demographics (age, gender, race, BMI) vaccination status, comorbidities (diabetes, asthma, COPD, peripheral vascular disease, coronary artery disease, anxiety, depression), and clinical outcomes (cognitive impairment, admission history, oxygen and ventilator requirement, Montreal Cognitive Assessment score, Modified Medical Research Council dyspnea score, Generalized Anxiety Disorder-7 score, and Patient Health Questionnaire-9 score). These were compared between four cohorts based on the predominant COVID variant obtained from the CDC website: before 12/31/20 (Initial), 1/1/21 – 3/30/21 (Epsilon), 3/31/21 – 6/12/21 (Alpha), 6/13/21 – 12/19/21 (Delta), 12/20/21 onwards (Omicron). Patients were included if they qualified for clinical definition of Long covid, had data on date of first COVID-positive test, completed Long COVID clinic assessment.

Results: 132 patients were identified from the Long COVID Clinic, 17 did not meet inclusion criteria and therefore were excluded. There were no significant differences in the demographics or co-morbidities among variants. Among all included patients, 37.63% were vaccinated before they were COVID-positive. Presenting symptoms of headache (p=0.02), diarrhea (p=0.006), and nausea/vomiting (p=0.02) were significantly different among variants. Most common presenting symptom among all variants were fatigue (83%), cough (79%), and myalgia (66%). Clinical outcomes did not vary significantly among variants, with the most common outcome including cognitive impairment (58%), admission status (43%), and oxygen requirement (25%).

Conclusions: Our analysis indicated most common presenting symptoms and those that differ among variants. Understanding the presenting symptoms and risk factors will help providers identify and appropriately refer patients with Long COVID.