{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T10:07:27Z","timestamp":1790676447045,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education, University and Research (Italy) Excellence Departments"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>COVID-19 has been associated with a broad range of long-term sequelae, commonly referred to as \u201clong-COVID\u201d or \u201cpost-COVID-19\u201d syndrome. Despite an increasing body of literature, long COVID remains poorly characterized. We retrospectively analysed data from electronic medical records of patients admitted to the post-COVID-19 outpatient service of the Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy, between June 2020 and June 2021, 4\u201312 weeks after hospital discharge. A total of 428 patients, 41% women, median age 64 years, underwent a follow-up visit a median 53 days after hospital discharge. Overall, 76% patients reported at least one persistent symptom, including dyspnoea (37%), chronic fatigue (36%), insomnia (16%), visual disorders (13%) and brain fog (13%). Increasing oxygen support (OR 1.4, 95% CI 1.1\u20131.8), use of immunosuppressants (OR 6.4, 95% CI 1.5\u201328) and female sex (OR 1.8, 95% CI 1.1\u20132.9) were associated with a higher risk of long COVID symptoms. Comparison between symptomatic patients infected in the period March\u2013December 2020 (prevalent circulation of wild-type SARS-CoV-2) with those infected in the period January\u2013April 2021 (prevalent circulation of B.1.1.7 Alpha variant) showed a significant modification in the pattern of symptoms belonging to the neurological and cognitive\/emotional categories. Our findings confirmed shortness of breath and chronic fatigue as the most frequent long COVID manifestations, while female sex and severe COVID-19 course were the main risk factors for developing lingering symptoms. SARS-CoV-2 variants may induce different long COVID phenotypes, possibly due to changes in cell tropism and differences in viral\u2013host interaction.<\/jats:p>","DOI":"10.3390\/v14112367","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T04:35:17Z","timestamp":1666845317000},"page":"2367","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Infection with SARS-CoV-2 Variants Is Associated with Different Long COVID Phenotypes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5377-7118","authenticated-orcid":false,"given":"Michele","family":"Spinicci","sequence":"first","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Graziani","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2097-2443","authenticated-orcid":false,"given":"Marta","family":"Tilli","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerusalem","family":"Nkurunziza","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3883-0766","authenticated-orcid":false,"given":"Iacopo","family":"Vellere","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Borchi","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Mencarini","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Campolmi","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Gori","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Giovannoni","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Amato","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Livi","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rasero","sequence":"additional","affiliation":[{"name":"Department of Health Science, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Fattirolli","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Cardiac Rehabilitation Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Marcucci","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Atherothrombotic Disease Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8708-9444","authenticated-orcid":false,"given":"Betti","family":"Giusti","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Atherothrombotic Disease Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iacopo","family":"Olivotto","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Cardiomyopathy Unit, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Tomassetti","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Department of Cardiothoracovascular Medicine, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Lavorini","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Department of Cardiothoracovascular Medicine, Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2862-9591","authenticated-orcid":false,"given":"Laura","family":"Maggi","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Flow Cytometry Diagnostic Center and Immunotherapy (CDCI), Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Annunziato","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Flow Cytometry Diagnostic Center and Immunotherapy (CDCI), Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8101-4695","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Marchionni","sequence":"additional","affiliation":[{"name":"Department of Experimental & Clinical Medicine, University of Florence, 50134 Florence, Italy"},{"name":"Department of Cardiothoracovascular Medicine, Careggi University Hospital, 50134 Florence, 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,27]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022). 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