Age-related differences in long COVID symptoms and outcomes: a cross-sectional study in Jordan

Background: Long coronavirus disease (COVID) causes persistent physical, psychological, and functional symptoms. This study compared symptom prevalence and outcomes between younger (<60 years) and older (≥60 years) Jordanian adults with long COVID. Methods: This cross-sectional study included adults with polymerase chain reaction-confirmed coronavirus disease 2019 (COVID-19) and symptoms persisting ≥2 months. An Arabic questionnaire was administered online or by telephone. Fatigue, functional status, dyspnea, and depressive symptoms were assessed using the Fatigue Severity Scale, Post-COVID-19 Functional Status (PCFS) scale, modified Medical Research Council scale, and Patient Health Questionnaire-9 (PHQ-9). Group comparisons and multivariable logistic regression were performed, adjusting for sex, smoking, comorbidity, and vaccination. Results: Among 938 participants, 596 (63.5%) were younger than 60 years. Fatigue was common in both groups (93.3% vs. 90.6%; P=0.143). Younger adults reported more dyspnea, muscle pain, dizziness, anxiety/depression, and brain fog (all P<0.05). Older adults had more severe functional limitation (PCFS grade 4: 24.6% vs. 16.1%; P=0.002) and greater depressive symptom severity (P=0.029). After adjustment, younger age was associated with lower odds of moderate-to-severe depressive symptoms (adjusted odds ratio [aOR], 0.624; 95% confidence interval [CI], 0.468-0.830; P=0.001), but not with severe functional limitation (aOR, 1.340; 95% CI, 0.949-1.891; P=0.096). Conclusion: Younger adults reported a broader range of symptoms, whereas older adults experienced greater functional impairment and depressive symptom severity. Age remained independently associated with depressive symptoms but not severe functional limitation.