{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:49:22Z","timestamp":1780584562133,"version":"3.54.1"},"reference-count":36,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Long COVID is now recognized as a common consequence of the SARS-CoV-2 infection, but we are still far from fully understanding its pathogenesis and predictive factors. Many pathophysiological factors have been studied, including ethnicity. To our knowledge, the risk factors for Long COVID have not been studied in Southeastern Italy. Aims: The aim of this study was to evaluate the predictive factors of Long COVID in a cohort of patients from Southeastern Italy. Methods: We conducted a retrospective longitudinal study, enrolling inpatients and outpatients diagnosed with COVID-19 from June 2021 to March 2022. A total of 436 subjects were evaluated in an outpatient setting 12 weeks after a SARS-CoV-2 infection, recording comorbidities, symptoms, therapy, and clinical information. Univariate and multivariate binomial logistic regression analyses were performed on different risk factors to define the probability of developing Long COVID. Results: A total of 71.8% of patients (313) developed Long COVID, while the remaining 123 (28.3%) had a complete remission of symptoms 3 months after acute infection. During the acute phase of COVID-19, 68.3% of patients experienced respiratory failure and 81.4% received corticosteroid therapy. In a multivariate analysis, the female sex (SEX M ODD 0.513) and corticosteroids (ODD 2.25) were maintained as predictive values. Conclusions: From our data and in line with other studies, the female sex emerges as a risk factor for Long COVID in the population of Southeastern Italy. Corticosteroid therapy administered in the acute phase also appears to be associated with an increased risk of Long COVID. Although indications for the prescription of corticosteroid therapy in the acute phase were indicated by the presence of pneumonia complicated by respiratory insufficiency, there was an over-prescription of corticosteroid therapy in the real life of our cohort, with 64% of patients having respiratory insufficiency and 81% having corticosteroid therapy. We hypothesize that a synergistic link between viral infection and the side effects of corticosteroid therapy may arise in selected cases.<\/jats:p>","DOI":"10.3390\/jcm12196303","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T09:39:32Z","timestamp":1695980372000},"page":"6303","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The Predictors of Long COVID in Southeastern Italy"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9920-780X","authenticated-orcid":false,"given":"Vitaliano Nicola","family":"Quaranta","sequence":"first","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Portacci","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1563-6864","authenticated-orcid":false,"given":"Silvano","family":"Dragonieri","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5797-1814","authenticated-orcid":false,"given":"Cristian","family":"Locorotondo","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Buonamico","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Diaferia","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Iorillo","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Quaranta","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna Elisiana","family":"Carpagnano","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, Section of Respiratory Disease, University \u201cAldo Moro\u201d of Bari, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2021). Living Guidance for Clinical Management of COVID-19 2021, World Health Organization (WHO). Available online: www.who.int\/publications\/i\/item\/WHO-2019-nCoV-clinical-2021-2."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","article-title":"Clinical characteristics of coronavirus disease","volume":"382","author":"Guan","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_3","unstructured":"National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, and the Royal College of General Practitioners (2022, March 03). COVID-19 Rapid Guideline: Managing the Long-Term Effects of COVID-19. Available online: www.nice.org.uk\/guidance\/ng188."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","article-title":"Long COVID: Major findings, mechanisms and recommendations","volume":"21","author":"Davis","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"m3026","DOI":"10.1136\/bmj.m3026","article-title":"Management of post-acute COVID-19 in primary care","volume":"370","author":"Greenhalgh","year":"2020","journal-title":"BMJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S0140-6736(20)32656-8","article-title":"6-Month consequences of COVID-19 in patients discharged from hospital: A cohort study","volume":"397","author":"Huang","year":"2021","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/fampra\/cmab076","article-title":"Post-acute and long-COVID-19 symptoms in patients with mild diseases: A systematic review","volume":"39","author":"Lucassen","year":"2022","journal-title":"Fam. Pract."},{"key":"ref_8","first-page":"1891","article-title":"COVID-19 Commission of the Accademia Nazionale dei Lincei. Long COVID: Where we stand and challenges ahead","volume":"29","author":"Mantovani","year":"2022","journal-title":"Cell Death Differ."},{"key":"ref_9","first-page":"jrm00063","article-title":"Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis","volume":"52","author":"Ahmed","year":"2020","journal-title":"J. Rehabil. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ladds, E., Rushforth, A., Wieringa, S., Taylor, S., Rayner, C., and Husain, L. (2020). Persistent symptoms after COVID-19: Qualitative study of 114 \u201clong COVID\u201d patients and draft quality principles for services. BMC Health Serv. Res., 20.","DOI":"10.1186\/s12913-020-06001-y"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/S0140-6736(22)01214-4","article-title":"Persistence of somatic symptoms after COVID-19 in the Netherlands: An observational cohort study","volume":"400","author":"Ballering","year":"2022","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.2147\/NDT.S382308","article-title":"HIV, HSV, SARS-CoV-2 and Ebola Share Long-Term Neuropsychiatric Sequelae","volume":"18","author":"Stefano","year":"2022","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jare.2021.11.013","article-title":"Analysis of post COVID-19 condition and its overlap with myalgic encephalomyelitis\/chronic fatigue syn-drome","volume":"40","author":"Sukocheva","year":"2022","journal-title":"J. Adv. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2102174","DOI":"10.1183\/13993003.02174-2021","article-title":"European Respiratory Society statement on long COVID follow-up","volume":"60","author":"Antoniou","year":"2022","journal-title":"Eur. Respir. J."},{"key":"ref_15","unstructured":"CDC (2022, December 18). Long COVID\u2014Household Pulse Survey\u2014COVID-19, Available online: https:\/\/www.cdc.gov\/nchs\/covid19\/pulse\/long-covid.htm."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic. Dis."},{"key":"ref_17","unstructured":"World Health Organization (2020, November 13). Clinical Practice Guideline on Corticosteroids for COVID-19. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-Corticosteroids-2020.1."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Bhimraj, A., Morgan, R.L., Shumaker, A.H., Baden, L., Cheng, V.C.C., Edwards, K.M., Gallagher, J.C., Gandhi, R.T., Muller, W.J., and Nakamura, M.M. (2022). Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Clin. Infect. Dis., ciac724.","DOI":"10.1093\/cid\/ciac724"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.cmi.2020.09.023","article-title":"Clinical sequelae of COVID-19 survivors in Wuhan, China: A single-centre longitudinal study","volume":"27","author":"Xiong","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S2215-0366(20)30203-0","article-title":"Psychiatric and neuropsychiatric presentations associated with severe HIV infections coronavirus: A systematic review and meta-analysis with respect to the COVID-19 pandemic","volume":"7","author":"Rogers","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.resinv.2021.05.002","article-title":"Risk factors for transfer from Respiratory Inter-mediate Care Unit to Intensive Care Unit in COVID-19","volume":"59","author":"Buonamico","year":"2021","journal-title":"Respir. Investig."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3389\/fpubh.2020.00152","article-title":"Gender Differences in Patients With COVID-19: Focus on Severity and Mortality","volume":"8","author":"Jin","year":"2020","journal-title":"Front. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.jsxm.2021.03.004","article-title":"Testosterone\u2019s Role in COVID-19","volume":"18","author":"Auerbach","year":"2021","journal-title":"J. Sex Med."},{"key":"ref_24","first-page":"CD015201","article-title":"Obesity as an independent risk factor for COVID-19 severity and mortality","volume":"5","author":"Rayner","year":"2023","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1001\/jamainternmed.2020.3539","article-title":"Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy","volume":"180","author":"Grasselli","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"9","DOI":"10.18332\/pne\/146178","article-title":"Baseline characteristics and outcome predictors in patients hospitalized with COVID-19 in the University General Hospital of Ioannina, Greece","volume":"35","author":"Quaranta","year":"2022","journal-title":"Pneumon"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Dessie, Z.G., and Zewotir, T. (2021). Mortality-related risk factors of COVID-19: A systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-06536-3"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.cmi.2022.01.014","article-title":"Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: A systematic review and meta-analysis","volume":"28","author":"Alkodaymi","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"975527","DOI":"10.3389\/fpubh.2022.975527","article-title":"Characteristics of Long-COVID care centers in Italy. A national survey of 124 clinical sites","volume":"10","author":"Floridia","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Jacobs, L.G., Gourna Paleoudis, E., Lesky-Di Bari, D., Nyirenda, T., Friedman, T., Gupta, A., Rasouli, L., Zetkulic, M., Balani, B., and Bawa, H. (2020). Persistence of symptoms and quality of life at 35 days after hospitalization for COVID-19 infection. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0243882"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"jrm00141","DOI":"10.2340\/16501977-2776","article-title":"Rehabilitation setting during and after COVID-19: An overview on recommendations","volume":"53","author":"Agostini","year":"2021","journal-title":"J. Rehabil. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.jinf.2021.01.004","article-title":"Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study","volume":"82","author":"Merino","year":"2021","journal-title":"J. Infect."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1177\/070674370705200405","article-title":"Stress and psychological distress among SARS survivors 1 year after the outbreak","volume":"52","author":"Lee","year":"2007","journal-title":"Can. J. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1177\/0897190021998502","article-title":"A Review of the Evidence for Corticosteroids in COVID-19","volume":"35","author":"Johns","year":"2022","journal-title":"J. Pharm. Pract."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"89","DOI":"10.5492\/wjccm.v5.i1.89","article-title":"Corticosteroids for severe influenza pneumonia: A critical appraisal","volume":"5","author":"Nedel","year":"2016","journal-title":"World J. Crit. Care Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1016\/j.chest.2021.06.010","article-title":"Systemic corticosteroids for management of \u2018long-COVID\u2019: An evaluation after 3 months of treatment","volume":"92","author":"Goel","year":"2021","journal-title":"Monaldi Arch Chest Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6303\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:02:12Z","timestamp":1760130132000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":36,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12196303"],"URL":"https:\/\/doi.org\/10.3390\/jcm12196303","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,29]]}}}