Citation: Krysa, J.A.; Buell, M.; Pohar
Manhas, K.; Kovacs Burns, K.;
Santana, M.J.; Horlick, S.; Russell, K.;
Papathanassoglou, E.; Ho, C.
Understanding the Experience of
Long COVID Symptoms in
Hospitalized and Non-Hospitalized
Individuals: A Random,
Cross-Sectional Survey Study.
Healthcare 2023, 11, 1309. https://
doi.org/10.3390/healthcare11091309
Academic Editors: Sofia Koukouli
and Areti Stavropoulou
Received: 21 March 2023
Revised: 21 April 2023
Accepted: 28 April 2023
Published: 3 May 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
healthcare
Article
Understanding the Experience of Long COVID Symptoms in
Hospitalized and Non-Hospitalized Individuals: A Random,
Cross-Sectional Survey Study
Jacqueline A. Krysa
1,2
, Mikayla Buell
1,3
, Kiran Pohar Manhas
1,3
, Katharina Kovacs Burns
4,5
, Maria J. Santana
3
,
Sidney Horlick
1,6
, Kristine Russell
1
, Elizabeth Papathanassoglou
1,6
and Chester Ho
1,2,
*
1
Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services,
Edmonton, AB T5J 3E4, Canada
2
Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB T6G 2E1, Canada
3
Community Health Sciences, Cumming School of Medicine, University of Calgary,
Calgary, AB T2N 1N4, Canada
4
School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
5
Department of Clinical Quality Metrics, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
6
Faculty of Nursing, University of Alberta, Edmonton AB T6G 1C9, Canada
* Correspondence: chester.ho@albertahealthservices.ca; Tel.: +1-780-735-8870
Abstract: The relationship between initial COVID-19 infection and the development of long COVID
remains unclear. The purpose of this study was to compare the experience of long COVID in
previously hospitalized and non-hospitalized adults in a community-based, cross-sectional telephone
survey. Participants included persons with positive COVID-19 test results between 21 March 2021
and 21 October 2021 in Alberta, Canada. The survey included 330 respondents (29.1% response rate),
which included 165 previously hospitalized and 165 non-hospitalized individuals. Significantly more
previously hospitalized respondents self-reported long COVID symptoms (81 (49.1%)) compared to
non-hospitalized respondents (42 (25.5%), p < 0.0001). Most respondents in both groups experienced
these symptoms for more than 6 months (hospitalized: 66 (81.5%); non-hospitalized: 25 (59.5),
p = 0.06). Hospitalized respondents with long COVID symptoms reported greater limitations on
everyday activities from their symptoms compared to non-hospitalized respondents (p < 0.0001) and
tended to experience a greater impact on returning to work (unable to return to work—hospitalized:
20 (19.1%); non-hospitalized: 6 (4.5%), p < 0.0001). No significant differences in self-reported long
COVID symptoms were found between male and female respondents in both groups (p > 0.05). This
study provides novel data to further support that individuals who were hospitalized for COVID-19
appear more likely to experience long COVID symptoms.
Keywords: long COVID; hospitalization; patient experience; COVID-19 recovery; COVID-19 severity
and impact
1. Introduction
In Canada, 4.42 million individuals have recovered from COVID-19, of which over
100,000 were hospitalized [1]. The World Health Organization defines post-COVID con-
ditions as any new, recurring, or lingering symptoms that persist for at least 12 weeks
following acute COVID-19 infection and cannot be explained by an alternative diagnosis [2].
Long COVID is a more general term used to describe new or ongoing signs and symptoms
that develop after recovery from acute COVID-19 and includes ongoing symptomatic
COVID-19 (4–12 weeks since initial recovery) and post-COVID conditions (12 weeks or
more since initial recovery) [3]. Current estimates of long COVID prevalence vary region-
ally and between COVID-19 variants [4,5]. The Canadian COVID-19 Antibody and Health
Survey (CCAHS-2) described the experience of long-term symptoms after a COVID-19
Healthcare 2023, 11, 1309. https://doi.org/10.3390/healthcare11091309 https://www.mdpi.com/journal/healthcare