Prevalence and determinants of long COVID and SARS-CoV-2 reinfection in the Spanish adult population: A nationwide public health survey

Medicina clinica (English ed.) Pub Date : 2026-09-01 Epub Date: 2026-09-25 DOI:10.1016/j.medcle.2026.107491

Carlos Rescalvo-Casas, Marcos Hernando-Gozalo, Lourdes Lledó-García, Juan Cuadros-González, Ramón Pérez-Tanoira

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Abstract

Introduction

Long COVID is an emerging public health concern with heterogeneous prevalence. Evidence on the impact of reinfection and vaccination remains limited, especially in Spain.

Methods

We conducted a prospective online cohort survey between January 2024 and April 2025, gathering data on demographics, vaccination, symptoms, comorbidities, and reinfection history from Spanish adults (n = 1018). Long COVID was defined per NICE guidelines as symptoms persisting beyond eight weeks after viral clearance. Multivariate logistic regression identified associated factors.

Results

Of 972 participants (332 men, 640 women), long COVID prevalence was 14.3% (n = 139). Female sex (OR: 1.70; 95% CI: 1.10–2.57; p = 0.014) and chronic obstructive pulmonary disease (COPD) (OR: 4.14; 95% CI: 1.28–13.42; p = 0.018) increased risk. Mixed vaccination schedules raised risk compared to Pfizer-only regimens (OR: 1.30; 95% CI: 1.04–1.62; p = 0.020). Reinfection, reported by 47.2%, was also a risk factor (OR: 1.64; 95% CI: 1.12–2.42; p = 0.012). Frequent long COVID symptoms included anosmia, dyspnea, pneumonia, and myalgia.

Conclusions

This national cohort underscores the persistent burden of long COVID in Spain. Female sex, COPD, reinfection, and mixed vaccination schedules are key associated factors, with implications for targeted prevention strategies and vaccination policies.

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西班牙成年人长期COVID和SARS-CoV-2再感染的流行率和决定因素：一项全国性公共卫生调查

COVID是一种新兴的公共卫生问题，具有异质性的流行。关于再感染和疫苗接种影响的证据仍然有限，特别是在西班牙。方法：我们在2024年1月至2025年4月期间进行了一项前瞻性在线队列调查，收集了西班牙成年人（n = 1018）的人口统计学、疫苗接种、症状、合并症和再感染史数据。根据NICE指南，长冠状病毒被定义为病毒清除后症状持续超过8周。多元逻辑回归确定了相关因素。结果972名参与者（男性332人，女性640人）中，长期流行率为14.3% （n = 139）。女性（OR: 1.70; 95% CI: 1.10-2.57; p = 0.014）和慢性阻塞性肺疾病（COPD）（OR: 4.14; 95% CI: 1.28-13.42; p = 0.018）的风险增加。与仅使用辉瑞的方案相比，混合疫苗接种计划增加了风险（OR: 1.30; 95% CI: 1.04-1.62; p = 0.020）。47.2%的患者报告再次感染也是危险因素（OR: 1.64; 95% CI: 1.12-2.42; p = 0.012）。常见的长时间COVID症状包括嗅觉丧失、呼吸困难、肺炎和肌痛。这一全国性队列强调了西班牙长期COVID的持续负担。女性性别、慢性阻塞性肺病、再感染和混合疫苗接种计划是关键的相关因素，对有针对性的预防策略和疫苗接种政策具有影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Medicina clinica (English ed.)

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