J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Letter to the Editor

Volume 13, Number 12, December 2021, pages 567-571

Six-Month Post-Acute COVID-19: High Self-Reported Morbidity Among Adults Younger Than Sixty Years and Females

**Table 1.** Self-Reported Post-Acute COVID Syndrome in Adults Younger Than 60 Versus Adults at or Older Than 60 Years
Modified GST-30 questionnaire	Age < 60 years, n = 38 (%)	Age ≥ 60 years, n = 19 (%)	P value
COVID-19: coronavirus disease 2019; SD: standard deviation; ICU: intensive care unit; ED: emergency department; PHQ-2: Patient Health Questionnaire-2.
Sex			0.05
Male	10 (26.3)	10 (52.6)
Female	28 (73.7)	9 (47.4)
Insurance-public	16 (42.1)	17 (89.5)	< 0.01
Comorbidities
Hypertension	20 (52.6)	17 (89.5)	< 0.01
Diabetes	15 (39.5)	9 (47.4)	0.57
Obesity	33 (86.8)	10 (62.5)	0.04
Mean Charlson score (SD)	0.61 (1.2)	1.6 (2.1)	0.03
COVID-19 symptoms at the time of hospitalization
Altered mental status	2 (5.3)	2 (10.5)	0.46
Shortness of breath	28 (73.7)	15 (78.9)	0.66
Cough	33 (86.8)	14 (73.7)	0.22
Fever	30 (78.9)	8 (42.1)	0.005
Fatigue	22 (57.9)	11 (57.9)	1.0
Muscle aches	16 (42.1)	9 (47.4)	0.71
Nausea/vomiting	9 (23.7)	7 (36.8)	0.30
Headaches	3 (7.9)	4 (21.1)	0.15
Severe COVID-19 pneumonia	7 (18.4)	2 (10.5)	0.56
Outcomes at the time of hospitalization
Ventilation	3 (7.9)	1 (5.3)	0.71
ICU admission	3 (7.9)	1 (5.3)	0.71
Length of hospitalization (SD)	7.0 (6.9)	5.7 (4.7)	0.40
Post COVID-19 sequelae
Mean time to survey (SD)	7.5 (0.47)	7.4 (0.47)	0.49
Any ED visit	5 (13.2)	3 (15.8)	0.79
Any hospital readmission	4 (10.5)	2 (10.5)	1.00
Any new symptom	15 (44.1)	12 (70.6)	0.07
Viral-like symptoms
Shortness of breath	21 (56.8)	11 (57.9)	0.94
Fever	5 (13.5)	5 (26.3)	0.24
Nausea and/or vomiting	6 (16.2)	4 (21.1)	0.66
Headaches	13 (35.1)	8 (42.1)	0.61
Fatigue symptoms
Back pain	15 (40.5)	10 (52.6)	0.39
Stiff or painful neck	11 (29.7)	9 (47.4)	0.19
Muscle aches or pain	19 (52.8)	9 (47.4)	0.70
Joint pain or swelling	15 (41.7)	9 (47.4)	0.69
Muscle weakness	10 (27.8)	9 (47.4)	0.15
Feeling fatigue or having low energy	21 (58.3)	12 (63.2)	0.73
Feeling worse than before after exercise or after normal physical exertion	14 (37.8)	11 (57.9)	0.15
Insomnia/trouble falling or staying asleep	11 (30.6)	6 (31.6)	0.94
Needing more sleep than usual	15 (41.7)	7 (38.9)	0.85
Not feeling rested on awakening	17 (47.2)	8 (42.1)	0.72
Neurological symptoms
Numbness and tingling	11 (30.6)	10 (55.6)	0.08
Shooting, stabbing and burning pains	11 (30.6)	6 (31.6)	0.94
Skin or muscle twitching	6 (16.7)	5 (26.3)	0.40
Discomfort with normal light and sound	5 (13.9)	2 (10.5)	0.72
Balance problems or sense of room-spinning	13 (36.1)	13 (68.4)	0.02
Change in visual clarity or trouble focusing	15 (41.7)	7 (36.8)	0.73
Bladder discomfort or change in urination	5 (13.9)	5 (26.3)	0.26
Light-headed or uncomfortable on standing	13 (36.1)	7 (36.8)	0.96
Hot or cold sensations in extremities	5 (13.9)	4 (21.1)	0.50
Irregular or rapid heart beats	13 (36.1)	8 (42.1)	0.66
Neuropsychiatric symptoms
Feeling irritable, sad or decreased pleasure	22 (61.1)	9 (47.4)	0.33
Feeling panicky, anxious or worried	22 (61.1)	7 (36.8)	0.09
Trouble finding words or retrieving names	14 (38.9)	7 (36.8)	0.88
Trouble with memory	19 (52.8)	12 (63.2)	0.46
Slower speed of thinking	17 (47.2)	11 (57.9)	0.45
Symptoms Impaired functioning	17 (45.9)	4 (21.1)	0.07
Major depression per PHQ-2	11 (29.7)	5 (26.3)	0.79

Table 1. Self-Reported Post-Acute COVID Syndrome in Adults Younger Than 60 Versus Adults at or Older Than 60 Years

Modified GST-30 questionnaire

Age < 60 years, n = 38 (%)

Age ≥ 60 years, n = 19 (%)

P value

COVID-19: coronavirus disease 2019; SD: standard deviation; ICU: intensive care unit; ED: emergency department; PHQ-2: Patient Health Questionnaire-2.

Sex

0.05

Male

10 (26.3)

10 (52.6)

Female

28 (73.7)

9 (47.4)

Insurance-public

16 (42.1)

17 (89.5)

< 0.01

Comorbidities

Hypertension

20 (52.6)

17 (89.5)

< 0.01

Diabetes

15 (39.5)

9 (47.4)

0.57

Obesity

33 (86.8)

10 (62.5)

0.04

Mean Charlson score (SD)

0.61 (1.2)

1.6 (2.1)

0.03

COVID-19 symptoms at the time of hospitalization

Altered mental status

2 (5.3)

2 (10.5)

0.46

Shortness of breath

28 (73.7)

15 (78.9)

0.66

Cough

33 (86.8)

14 (73.7)

0.22

Fever

30 (78.9)

8 (42.1)

0.005

Fatigue

22 (57.9)

11 (57.9)

1.0

Muscle aches

16 (42.1)

9 (47.4)

0.71

Nausea/vomiting

9 (23.7)

7 (36.8)

0.30

Headaches

3 (7.9)

4 (21.1)

0.15

Severe COVID-19 pneumonia

7 (18.4)

2 (10.5)

0.56

Outcomes at the time of hospitalization

Ventilation

3 (7.9)

1 (5.3)

0.71

ICU admission

3 (7.9)

1 (5.3)

0.71

Length of hospitalization (SD)

7.0 (6.9)

5.7 (4.7)

0.40

Post COVID-19 sequelae

Mean time to survey (SD)

7.5 (0.47)

7.4 (0.47)

0.49

Any ED visit

5 (13.2)

3 (15.8)

0.79

Any hospital readmission

4 (10.5)

2 (10.5)

1.00

Any new symptom

15 (44.1)

12 (70.6)

0.07

Viral-like symptoms

Shortness of breath

21 (56.8)

11 (57.9)

0.94

Fever

5 (13.5)

5 (26.3)

0.24

Nausea and/or vomiting

6 (16.2)

4 (21.1)

0.66

Headaches

13 (35.1)

8 (42.1)

0.61

Fatigue symptoms

Back pain

15 (40.5)

10 (52.6)

0.39

Stiff or painful neck

11 (29.7)

9 (47.4)

0.19

Muscle aches or pain

19 (52.8)

9 (47.4)

0.70

Joint pain or swelling

15 (41.7)

9 (47.4)

0.69

Muscle weakness

10 (27.8)

9 (47.4)

0.15

Feeling fatigue or having low energy

21 (58.3)

12 (63.2)

0.73

Feeling worse than before after exercise or after normal physical exertion

14 (37.8)

11 (57.9)

0.15

Insomnia/trouble falling or staying asleep

11 (30.6)

6 (31.6)

0.94

Needing more sleep than usual

15 (41.7)

7 (38.9)

0.85

Not feeling rested on awakening

17 (47.2)

8 (42.1)

0.72

Neurological symptoms

Numbness and tingling

11 (30.6)

10 (55.6)

0.08

Shooting, stabbing and burning pains

11 (30.6)

6 (31.6)

0.94

Skin or muscle twitching

6 (16.7)

5 (26.3)

0.40

Discomfort with normal light and sound

5 (13.9)

2 (10.5)

0.72

Balance problems or sense of room-spinning

13 (36.1)

13 (68.4)

0.02

Change in visual clarity or trouble focusing

15 (41.7)

7 (36.8)

0.73

Bladder discomfort or change in urination

5 (13.9)

5 (26.3)

0.26

Light-headed or uncomfortable on standing

13 (36.1)

7 (36.8)

0.96

Hot or cold sensations in extremities

5 (13.9)

4 (21.1)

0.50

Irregular or rapid heart beats

13 (36.1)

8 (42.1)

0.66

Neuropsychiatric symptoms

Feeling irritable, sad or decreased pleasure

22 (61.1)

9 (47.4)

0.33

Feeling panicky, anxious or worried

22 (61.1)

7 (36.8)

0.09

Trouble finding words or retrieving names

14 (38.9)

7 (36.8)

0.88

Trouble with memory

19 (52.8)

12 (63.2)

0.46

Slower speed of thinking

17 (47.2)

11 (57.9)

0.45

Symptoms Impaired functioning

17 (45.9)

4 (21.1)

0.07

Major depression per PHQ-2

11 (29.7)

5 (26.3)

0.79

**Table 2.** Self-Reported Post-Acute COVID Syndrome in Female Versus Male Adults
Modified GST-30 Questionnaire	Males, n = 20 (%)	Females, n = 37 (%)	P value
COVID-19: coronavirus disease 2019; SD: standard deviation; ICU: intensive care unit; ED: emergency department; GSQ: General Symptom Questionnaire; PHQ-2: Patient Health Questionnaire-2.
Race			0.7
White	2 (10)	5 (13.5)
Black/African-American	18 (90)	32 (86.5)
Insurance-public	14 (70.0)	19 (51.4)	0.17
Comorbidities
Hypertension	14 (70%)	23(62.2)	0.55
Diabetes	10 (50.0)	14 (37.8)	0.38
Obesity	10 (55.6)	33 (91.7)	0.002
COVID-19 symptoms at the time of hospitalization
Altered mental status	2 (10.0)	2 (5.4)	0.52
Shortness of breath	13 (65.0)	30 (81.1)	0.18
Cough	15 (75.0)	32 (86.5)	0.28
Fever	11 (55.0)	27 (73.0)	0.17
Fatigue	11 (55.0)	22 (66.7)	0.75
Muscle aches	8 (40.0)	17 (45.9)	0.67
Nausea/vomiting	4 (20.0)	12 (32.4)	0.32
Headaches	2 (10.0)	5 (13.5)	0.70
Outcomes at the time of hospitalization
Ventilation	1 (5.0)	3 (8.1)	0.66
ICU admission	1 (5.0)	3 (8.1)	0.66
Length of hospitalization (SD)	6.1 (4.2)	6.9 (7.2)	0.60
Post COVID-19 sequelae
Any ED visit	2 (10.0)	6 (16.2)	0.52
Any hospital readmission	2 (10.0)	4 (10.8)	0.92
Any new symptom	8 (44.4)	19 (57.6)	0.37
Mean GSQ score (SD)	20.2 (19.3)	35.1 (26.5)	0.02
Viral-like symptoms
Shortness of breath	8 (42.1)	24 (64.9)	0.10
Fever	3 (15.8)	7 (18.9)	0.77
Nausea and/or vomiting	1 (5.3)	9 (24.3)	0.08
Headaches	4 (21.1)	17 (45.9)	0.07
Fatigue symptoms
Back pain	6 (31.6)	19 (51.4)	0.16
Stiff or painful neck	4 (21.1)	16 (43.2)	0.10
Muscle aches or pain	11 (57.9)	17 (47.2)	0.45
Joint pain or swelling	6 (31.6)	18 (50.0)	0.19
Muscle weakness	6 (31.6)	13 (36.1)	0.74
Feeling fatigue or having low energy	10 (52.6)	23 (63.9)	0.42
Feeling worse than before after exercise or after normal physical exertion	7 (36.8)	18 (48.6)	0.40
Insomnia/trouble falling or staying asleep	4 (21.1)	13 (36.1)	0.25
Needing more sleep than usual	4 (22.2)	18 (50.0)	0.05
Not feeling rested on awakening	5 (26.3)	20 (55.6)	0.04
Neurological symptoms
Numbness and tingling	7 (38.9)	14 (38.9)	1.00
Shooting, stabbing and burning pains	2 (10.5)	15 (41.7)	0.02
Skin or muscle twitching	2 (10.5)	9 (25.0)	0.20
Discomfort with normal light and sound	0 (0.0)	7 (19.4)	0.04
Balance problems or sense of room-spinning	7 (36.8)	19 (52.8)	0.26
Change in visual clarity or trouble focusing	6 (31.6)	16 (44.4)	0.35
Bladder discomfort or change in urination	3 (15.8)	7 (19.4)	0.74
Light-headed or uncomfortable on standing	4 (21.1)	16 (44.4)	0.09
Hot or cold sensations in extremities	1 (5.3)	8 (22.2)	0.11
Irregular or rapid heart beats	4 (21.1)	17 (47.2)	0.06
Neuropsychiatric symptoms
Feeling irritable, sad or decreased pleasure	6 (31.6)	25 (69.4)	0.007
Feeling panicky, anxious or worried	4 (21.1)	25 (69.4)	0.001
Trouble finding words or retrieving names	5 (26.3)	16 (44.4)	0.19
Trouble with memory	7 (36.8)	24 (66.7)	0.03
Slower speed of thinking	8 (42.1)	20 (55.6)	0.34
Symptoms impaired functioning	7 (35.0)	14 (38.9)	0.77
Major depression per PHQ-2	3 (15.0)	13 (36.1)	0.09

Table 2. Self-Reported Post-Acute COVID Syndrome in Female Versus Male Adults

Modified GST-30 Questionnaire

Males, n = 20 (%)

Females, n = 37 (%)

P value

COVID-19: coronavirus disease 2019; SD: standard deviation; ICU: intensive care unit; ED: emergency department; GSQ: General Symptom Questionnaire; PHQ-2: Patient Health Questionnaire-2.

Race

0.7

White

2 (10)

5 (13.5)

Black/African-American

18 (90)

32 (86.5)

Insurance-public

14 (70.0)

19 (51.4)

0.17

Comorbidities

Hypertension

14 (70%)

23(62.2)

0.55

Diabetes

10 (50.0)

14 (37.8)

0.38

Obesity

10 (55.6)

33 (91.7)

0.002

COVID-19 symptoms at the time of hospitalization

Altered mental status

2 (10.0)

2 (5.4)

0.52

Shortness of breath

13 (65.0)

30 (81.1)

0.18

Cough

15 (75.0)

32 (86.5)

0.28

Fever

11 (55.0)

27 (73.0)

0.17

Fatigue

11 (55.0)

22 (66.7)

0.75

Muscle aches

8 (40.0)

17 (45.9)

0.67

Nausea/vomiting

4 (20.0)

12 (32.4)

0.32

Headaches

2 (10.0)

5 (13.5)

0.70

Outcomes at the time of hospitalization

Ventilation

1 (5.0)

3 (8.1)

0.66

ICU admission

1 (5.0)

3 (8.1)

0.66

Length of hospitalization (SD)

6.1 (4.2)

6.9 (7.2)

0.60

Post COVID-19 sequelae

Any ED visit

2 (10.0)

6 (16.2)

0.52

Any hospital readmission

2 (10.0)

4 (10.8)

0.92

Any new symptom

8 (44.4)

19 (57.6)

0.37

Mean GSQ score (SD)

20.2 (19.3)

35.1 (26.5)

0.02

Viral-like symptoms

Shortness of breath

8 (42.1)

24 (64.9)

0.10

Fever

3 (15.8)

7 (18.9)

0.77

Nausea and/or vomiting

1 (5.3)

9 (24.3)

0.08

Headaches

4 (21.1)

17 (45.9)

0.07

Fatigue symptoms

Back pain

6 (31.6)

19 (51.4)

0.16

Stiff or painful neck

4 (21.1)

16 (43.2)

0.10

Muscle aches or pain

11 (57.9)

17 (47.2)

0.45

Joint pain or swelling

6 (31.6)

18 (50.0)

0.19

Muscle weakness

6 (31.6)

13 (36.1)

0.74

Feeling fatigue or having low energy

10 (52.6)

23 (63.9)

0.42

Feeling worse than before after exercise or after normal physical exertion

7 (36.8)

18 (48.6)

0.40

Insomnia/trouble falling or staying asleep

4 (21.1)

13 (36.1)

0.25

Needing more sleep than usual

4 (22.2)

18 (50.0)

0.05

Not feeling rested on awakening

5 (26.3)

20 (55.6)

0.04

Neurological symptoms

Numbness and tingling

7 (38.9)

14 (38.9)

1.00

Shooting, stabbing and burning pains

2 (10.5)

15 (41.7)

0.02

Skin or muscle twitching

2 (10.5)

9 (25.0)

0.20

Discomfort with normal light and sound

0 (0.0)

7 (19.4)

0.04

Balance problems or sense of room-spinning

7 (36.8)

19 (52.8)

0.26

Change in visual clarity or trouble focusing

6 (31.6)

16 (44.4)

0.35

Bladder discomfort or change in urination

3 (15.8)

7 (19.4)

0.74

Light-headed or uncomfortable on standing

4 (21.1)

16 (44.4)

0.09

Hot or cold sensations in extremities

1 (5.3)

8 (22.2)

0.11

Irregular or rapid heart beats

4 (21.1)

17 (47.2)

0.06

Neuropsychiatric symptoms

Feeling irritable, sad or decreased pleasure

6 (31.6)

25 (69.4)

0.007

Feeling panicky, anxious or worried

4 (21.1)

25 (69.4)

0.001

Trouble finding words or retrieving names

5 (26.3)

16 (44.4)

0.19

Trouble with memory

7 (36.8)

24 (66.7)

0.03

Slower speed of thinking

8 (42.1)

20 (55.6)

0.34

Symptoms impaired functioning

7 (35.0)

14 (38.9)

0.77

Major depression per PHQ-2

3 (15.0)

13 (36.1)

0.09