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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Research Ethics Board of the Montreal Regional Health Authority gave ethical approval for this work (project #2022-1582). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The data used in this study cannot be made publicly available.