Chronic Lung Disease as a Risk Factor for Long COVID in Patients Diagnosed With Coronavirus Disease 2019: A Retrospective Cohort Study
Authors: Zhang Xiaotong , Anzalone Alfred Jerrod , Dai Daisy , Cochran Gary , Dai Ran , Rupp Mark E ,   for the National COVID Cohort (N3C) Collaborative, Wilcox Adam B , Lee Adam M , Graves Alexis , Anzalone Alfred (Jerrod) , Manna Amin , Saha Amit , Olex Amy , Zhou Andrea , Williams Andrew E , Southerland Andrew , Girvin Andrew T , Walden Anita , Sharathkumar Anjali A , Amor Benjamin , Bates Benjamin , Hendricks Brian , Patel Brijesh , Alexander Caleb , Bramante Carolyn , Ward-Caviness Cavin , Madlock-Brown Charisse , Suver Christine , Chute Christopher , Dillon Christopher , Wu Chunlei , Schmitt Clare , Takemoto Cliff , Housman Dan , Gabriel Davera , Eichmann David A , Mazzotti Diego , Brown Don , Boudreau Eilis , Hill Elaine , Zampino Elizabeth , Marti Emily Carlson , Pfaff Emily R , French Evan , Koraishy Farrukh M , Mariona Federico , Prior Fred , Sokos George , Martin Greg , Lehmann Harold , Spratt Heidi , Mehta Hemalkumar , Liu Hongfang , Sidky Hythem , Awori Hayanga J W , Pincavitch Jami , Clark Jaylyn , Harper Jeremy Richard , Islam Jessica , Ge Jin , Gagnier Joel , Saltz Joel H , Saltz Joel , Loomba Johanna , Buse John , Mathew Jomol , Rutter Joni L , McMurry Julie A , Guinney Justin , Starren Justin , Crowley Karen , Bradwell Katie Rebecca , Walters Kellie M , Wilkins Ken , Gersing Kenneth R , Cato Kenrick Dwain , Murray Kimberly , Kostka Kristin , Northington Lavance , Pyles Lee Allan , Misquitta Leonie , Cottrell Lesley , Portilla Lili , Deacy Mariam , Bissell Mark M , Clark Marshall , Emmett Mary , Saltz Mary Morrison , Palchuk Matvey B , Haendel Melissa A , Adams Meredith , Temple-O’Connor Meredith , Kurilla Michael G , Morris Michele , Qureshi Nabeel , Safdar Nasia , Garbarini Nicole , Sharafeldin Noha , Sadan Ofer , Francis Patricia A , Burgoon Penny Wung , Robinson Peter , Payne Philip R O , Fuentes Rafael , Jawa Randeep , Erwin-Cohen Rebecca , Patel Rena , Moffitt Richard A , Zhu Richard L , Kamaleswaran Rishi , Hurley Robert , Miller Robert T , Pyarajan Saiju , Michael Sam G , Bozzette Samuel , Mallipattu Sandeep , Vedula Satyanarayana , Chapman Scott , O’Neil Shawn T , Setoguchi Soko , Hong Stephanie S , Johnson Steve , Bennett Tellen D , Callahan Tiffany , Topaloglu Umit , Sheikh Usman , Gordon Valery , Subbian Vignesh , Kibbe Warren A , Hernandez Wenndy , Beasley Will , Cooper Will , Hillegass William , Zhang Xiaohan Tanner 
Published: August 2024

Abstract

Background
Patients with coronavirus disease 2019 (COVID-19) often experience persistent symptoms, known as postacute sequelae of COVID-19 or long COVID, after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Chronic lung disease (CLD) has been identified in small-scale studies as a potential risk factor for long COVID.

Methods
This large-scale retrospective cohort study using the National COVID Cohort Collaborative data evaluated the link between CLD and long COVID over 6 months after acute SARS-CoV-2 infection. We included adults (aged ≥18 years) who tested positive for SARS-CoV-2 during any of 3 SARS-CoV-2 variant periods and used logistic regression to determine the association, considering a comprehensive list of potential confounding factors, including demographics, comorbidities, socioeconomic conditions, geographical influences, and medication.

Results
Of 1 206 021 patients, 1.2% were diagnosed with long COVID. A significant association was found between preexisting CLD and long COVID (adjusted odds ratio [aOR], 1.36). Preexisting obesity and depression were also associated with increased long COVID risk (aOR, 1.32 for obesity and 1.29 for depression) as well as demographic factors including female sex (aOR, 1.09) and older age (aOR, 1.79 for age group 40–65 [vs 18–39] years and 1.56 for &gt;65 [vs 18–39] years).

Conclusions
CLD is associated with higher odds of developing long COVID within 6 months after acute SARS-CoV-2 infection. These data have implications for identifying high-risk patients and developing interventions for long COVID in patients with CLD.