Chapter 4 108 Determinants of time to recovery from symptoms Female participants experienced a 35% slower recovery than males (aHR 0.65 [95%CI=0.470.92]). In addition, obese participants recovered 38% more slowly than those of normal weight, when adjusting for age, sex and comorbidities (aHR 0.62 [95%CI=0.39-0.97]) (Figure 2). The proportional hazards assumption was met for all covariates included in the model. When restricting the analysis to prospectively-enrolled participants, the effect of BMI was attenuated, suggesting that including retrospectively-enrolled participants, with more severe/critical disease and higher BMI, strongly influenced estimates of recovery time (Figure S5). Figure 2. Unadjusted and adjusted hazard ratios of time to complete recovery for age, sex, BMI and number of comorbidities at illness onset Determinants at illness onset HR (95%CI) P-value Age, years Age (per 10 year increase) 0.86 (0.78-0.96) 0.005 Sex Male Ref. 0.051 Female 0.72 (0.52-1.00) BMI, kg/m2 Normal weight Ref. 0.007 Overweight 0.70 (0.49-1.01) Obese 0.53 (0.34-0.81) Number of comorbidities None Ref. 0.035 1 0.69 (0.46-1.02) 2 0.54 (0.31-0.94) 3 or more 0.62 (0.34-1.13) .1.2 .5 1 2 510 HR (95%CI) Univariable Cox proportional hazard model Determinants at illness onset aHR (95%CI) P-value Age, years Age (per 10 year increase) 0.92 (0.82-1.04) 0.200 Sex Male Ref. 0.013 Female 0.65 (0.47-0.92) BMI, kg/m2 Normal weight Ref. 0.057 Overweight 0.71 (0.49-1.03) Obese 0.62 (0.39-0.97) Number of comorbidities None Ref. 0.454 1 0.78 (0.50-1.21) 2 0.67 (0.37-1.23) 3 or more 0.72 (0.36-1.42) .1.2 .5 1 2 510 aHR (95%CI) Multivariable Cox proportional hazard model Determinants at illness onset HR (95%CI) P-value Age, years Age (per 10 year increase) 0.86 (0.78-0.96) 0.005 Sex Male Ref. 0.051 Female 0.72 (0.52-1.00) BMI, kg/m2 Normal weight Ref. 0.007 Overweight 0.70 (0.49-1.01) Obese 0.53 (0.34-0.81) Number of comorbidities None Ref. 0.035 1 0.69 (0.46-1.02) 2 0.54 (0.31-0.94) 3 or more 0.62 (0.34-1.13) .1.2 .5 1 2 510 HR (95%CI) Univariable Cox proportional hazard model Determinants at illness onset aHR (95%CI) P-value Age, years Age (per 10 year increase) 0.92 (0.82-1.04) 0.200 Sex Male Ref. 0.013 Female 0.65 (0.47-0.92) BMI, kg/m2 Normal weight Ref. 0.057 Overweight 0.71 (0.49-1.03) Obese 0.62 (0.39-0.97) Number of comorbidities None Ref. 0.454 1 0.78 (0.50-1.21) 2 0.67 (0.37-1.23) 3 or more 0.72 (0.36-1.42) .1.2 .5 1 2 510 aHR (95%CI) Multivariable Cox proportional hazard model Comorbidities counted are those listed by the WHO as being associated with a higher risk of developing severe or critical COVID-19[11, excluding BMI]. BMI categorised in kg/m2 as: <25, underweight or normal weight; 25 up to 30, overweight; >30, obese. P-value calculated using likelihood ratio test. In multivariable analysis of time to recovery for each of the four most persistent symptoms (Table S2a-d), being obese at illness onset was associated with slower recovery from loss of smell and/or taste (aHR 0.51, 95%CI=0.32-0.82). Increased age was associated with slower recovery from dyspnoea (aHR 0.80, 95%CI=0.69-0.93) and myalgia
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