Persisting symptoms after COVID-19 infection: a population-based study in Slovakia

Background

A substantial proportion of individuals experience persistent symptoms months or years after COVID-19 infection. Evidence on the population‑level burden of post‑COVID symptoms in Central Europe remains limited. This study aimed to estimate and compare the prevalence of persistent symptoms among individuals with prior COVID-19 infection and those never infected in Slovakia.

Methods

In 2025, a nationally representative survey was conducted in Slovakia among 1,500 respondents with a self-reported history of COVID-19. In addition, 600 respondents who reported never having been infected were surveyed. Current symptoms were assessed using a questionnaire based on the WHO’s Post COVID case report form. Thirty-two symptoms were evaluated. Logistic regression models were applied using R to estimate odds ratios (ORs) and 95% confidence intervals (CI). A p-value < 0.05 was considered statistically significant.

Results

Almost all assessed symptoms were more prevalent among respondents with previous COVID-19 infection compared to those without. The highest ORs were observed for facial pain or swelling (OR = 4.74; 95% CI: 2.38–9.44), fever (OR = 4.34; 95% CI: 2.38–7.91), inability to move or feel one side of the body or face (OR = 3.59; 95% CI: 1.85–6.95), pain on breathing (OR = 3.38; 95% CI: 1.99–5.73), reduced taste (OR = 3.24; 95% CI: 2.11–4.97), reduced smell (OR 2.74; 95% CI: 1.88–3.99), nausea/vomiting (OR = 2.49; 95% CI: 1.67–3.72), persistent dry cough (OR = 2.29; 95% CI: 1.62–3.25) and loss of appetite (OR = 2.16, 95% CI: 1.44–3.23) (p < 0.05). The associations remained statistically significant after adjustment for sociodemographic factors.

Conclusions

Individuals with a history of COVID-19 infection in Slovakia experience a significantly higher burden of persistent symptoms compared to those never been infected. These findings highlight the long-term health impact of COVID-19 and the need for targeted post-COVID care and public health planning.

Key messages

• People with prior COVID‑19 infection in Slovakia report a significantly higher prevalence of persistent symptoms than those never infected.

• The findings underscore the long‑term population burden of post‑COVID conditions and the need for targeted health services and planning.