Severe Fatigue and Persistent Symptoms at 3 Months Following Severe Acute Respiratory Syndrome Coronavirus 2 Infections During the Pre-Delta, Delta, and Omicron Time Periods: A Multicenter Prospective Cohort Study-Reference-Cited by-同舟云学术

Severe Fatigue and Persistent Symptoms at 3 Months Following Severe Acute Respiratory Syndrome Coronavirus 2 Infections During the Pre-Delta, Delta, and Omicron Time Periods: A Multicenter Prospective Cohort Study

Published:2023-01-27 Issue:11 Volume:76 Page:1930-1941
ISSN:1058-4838
Container-title:Clinical Infectious Diseases
language:en
Short-container-title:

Author:

Gottlieb Michael¹^ORCID,Wang Ralph C²^ORCID,Yu Huihui³⁴,Spatz Erica S³⁵,Montoy Juan Carlos C²,Rodriguez Robert M⁶^ORCID,Chang Anna Marie⁷,Elmore Joann G⁸^ORCID,Hannikainen Paavali A⁹,Hill Mandy¹⁰,Huebinger Ryan M¹⁰,Idris Ahamed H¹¹,Lin Zhenqiu³⁴,Koo Katherine¹²,McDonald Samuel¹¹¹³,O’Laughlin Kelli N¹⁴,Plumb Ian D¹⁵^ORCID,Santangelo Michelle¹²,Saydah Sharon¹⁵,Willis Michael¹⁴,Wisk Lauren E⁸^ORCID,Venkatesh Arjun³¹⁶^ORCID,Stephens Kari A¹⁷¹⁸,Weinstein Robert A¹²¹⁹^ORCID,Weinstein Robert A,Gottlieb Michael,Santangelo Michelle,Koo Katherine,Derden Antonia,Gottlieb Michael,Gatling Kristyn,Guzman Diego,Yang Geoffrey,Kaadan Marshall,Hassaballa Minna,Jerger Ryan,Ahmed Zohaib,Choi Michael,Venkatesh Arjun,Spatz Erica,Lin Zhenqiu,Li Shu-Xia,Yu Huihui,Mannan Imtiaz Ebna,Yang Zimo,Venkatesh Arjun,Spatz Erica,Ulrich Andrew,Kinsman Jeremiah,Dorney Jocelyn,Pierce Senyte,Puente Xavier,Nichol Graham,Stephens Kari,Anderson Jill,Morse Dana,Adams Karen,Maat Zenoura,Stober Tracy,O'Laughlin Kelli N,Gentile Nikki,Geyer Rachel E,Willis Michael,Ruiz Luis,Malone Kerry,Park Jasmine,Rising Kristin,Kean Efrat,Kelly Morgan,Schaeffer Kevin,Hannikainen Paavali,Shughart Lindsey,Shughart Hailey,Renzi Nicole,Amadio Grace,Grau Dylan,Watts Phillip,Cheng David,Miao Jessica,Shutty Carly,Charlton Alex,Hill Mandy,Site Ryan Huebinger,Chavez Summer,Kane Arun,Nikonowicz Peter,Idris Ahamed H,McDonald Samuel,Gallegos David,Martin Riley,Elmore Joann G,Wisk Lauren E,L'Hommedieu Michelle,Chandler Christopher W,Eguchi Megan,Roldan Kate Diaz,Moreno Raul,Rodriguez Robert M,Wang Ralph C,Montoy Juan Carlos C,Kemball Robin,Chan Virginia,Chavez Cecilia Lara,Wong Angela,Arreguin Mireya,Plumb Ian D,Hall Aron J,Saydah Sharon,Briggs-Hagen Melissa,

Affiliation:

1. Department of Emergency Medicine, Rush University Medical Center , Chicago, Illinois , USA

2. Department of Emergency Medicine, University of California , San Francisco, California , USA

3. Center for Outcomes Research and Evaluation, Yale School of Medicine , New Haven, Connecticut , USA

4. Section of Cardiovascular Medicine, Yale School of Medicine , New Haven, Connecticut , USA

5. Department of Epidemiology, Yale School of Public Health , New Haven, Connecticut , USA

6. Department of Emergency Medicine, University of California – San Francisco School of Medicine , San Francisco, California , USA

7. Department of Emergency Medicine, Thomas Jefferson University , Philadelphia, Pennsylvania , USA

8. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California – Los Angeles , Los Angeles, California , USA

9. Sidney Kimmel Medical College, Thomas Jefferson University , Philadelphia, Pennsylvania , USA

10. Department of Emergency Medicine, UTHealth Houston , Houston, Texas , USA

11. Department of Emergency Medicine, University of Texas Southwestern Medical Center , Dallas, Texas , USA

12. Department of Medicine, Division of Infectious Diseases, Rush University Medical Center , Chicago, Illinois , USA

13. Clinical Informatics Center, University of Texas Southwestern Medical Center , Dallas, Texas , USA

14. Department of Global Health, University of Washington , Seattle, Washington , USA

15. National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia , USA

16. Department of Emergency Medicine, Yale School of Medicine , New Haven, Connecticut , USA

17. Department of Biomedical Informatics and Medical Education, University of Washington , Seattle, Washington , USA

18. Department of Psychiatry and Behavioral Sciences, University of Washington , Seattle, Washington , USA

19. Department of Medicine, Division of Infectious Diseases, Cook County Hospital , Chicago, Illinois , USA

Abstract

Abstract Background Most research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants focuses on initial symptomatology with limited longer-term data. We characterized prevalences of prolonged symptoms 3 months post–SARS-CoV-2 infection across 3 variant time-periods (pre-Delta, Delta, and Omicron). Methods This multicenter prospective cohort study of adults with acute illness tested for SARS-CoV-2 compared fatigue severity, fatigue symptoms, organ system–based symptoms, and ≥3 symptoms across variants among participants with a positive (“COVID-positive”) or negative SARS-CoV-2 test (“COVID-negative”) at 3 months after SARS-CoV-2 testing. Variant periods were defined by dates with ≥50% dominant strain. We performed multivariable logistic regression modeling to estimate independent effects of variants adjusting for sociodemographics, baseline health, and vaccine status. Results The study included 2402 COVID-positive and 821 COVID-negative participants. Among COVID-positives, 463 (19.3%) were pre-Delta, 1198 (49.9%) Delta, and 741 (30.8%) Omicron. The pre-Delta COVID-positive cohort exhibited more prolonged severe fatigue (16.7% vs 11.5% vs 12.3%; P = .017) and presence of ≥3 prolonged symptoms (28.4% vs 21.7% vs 16.0%; P < .001) compared with the Delta and Omicron cohorts. No differences were seen in the COVID-negatives across time-periods. In multivariable models adjusted for vaccination, severe fatigue and odds of having ≥3 symptoms were no longer significant across variants. Conclusions Prolonged symptoms following SARS-CoV-2 infection were more common among participants infected during pre-Delta than with Delta and Omicron; however, these differences were no longer significant after adjusting for vaccination status, suggesting a beneficial effect of vaccination on risk of long-term symptoms. Clinical Trials Registration. NCT04610515.

Funder

National Center for Immunization and Respiratory Diseases, CDC

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Link

https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciad045/49289458/ciad045.pdf

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