Recovery and symptom trajectories up to two years after SARS-CoV-2 infection: population based, longitudinal cohort study

BMJ, Journal Year: 2023, Volume and Issue: unknown, P. e074425 - e074425

Published: May 31, 2023

To evaluate longer term symptoms and health outcomes associated with post-covid-19 condition within a cohort of individuals SARS-CoV-2 infection.Population based, longitudinal cohort.General population canton Zurich, Switzerland.1106 adults confirmed infection who were not vaccinated before 628 did have an infection.Trajectories self-reported status covid-19 related between months six, 12, 18, 24 after excess risk at six compared had no infection.22.9% (95% confidence interval 20.4% to 25.6%) infected fully recover by months. The proportion reported having recovered decreased 18.5% (16.2% 21.1%) 12 17.2% (14.0% 20.8%) infection. When assessing changes in status, most participants continued recovery (68.4% (63.8% 72.6%)) or overall improvement (13.5% (10.6% 17.2%)) over time. Yet, 5.2% (3.5% 7.7%) worsening 4.4% (2.9% 6.7%) alternating periods impairment. point prevalence severity also time, 18.1% (14.8% 21.9%) reporting 8.9% (6.5% 11.2%) all four follow-up time points, while 12.5% (9.8% 15.9%) alternatingly absent present. Symptom was higher among those (adjusted difference 17.0% (11.5% 22.4%)). Excess difference) for individual ranged from 2% 10%, the highest risks observed altered taste smell (7.7% 11.8%)), post-exertional malaise (9.4% (6.1% 12.7%)), fatigue (5.4% (1.2% 9.5%)), dyspnoea (7.8% (5.2% 10.4%)), reduced concentration (8.3% (6.0% 10.7%)) memory (5.7% 7.9%)).Up 18% up two years infection, evidence symptom controls. Effective interventions are needed reduce burden condition. Use multiple outcome measures consideration expected rates heterogeneity trajectories important design interpretation clinical trials.ISRCTN18181860, .

Language: Английский

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Long-term post-acute sequelae of COVID-19 infection: a retrospective, multi-database cohort study in Hong Kong and the UK

EClinicalMedicine, Journal Year: 2023, Volume and Issue: 60, P. 102000 - 102000

Published: May 11, 2023

Evidence on post-acute sequelae of SARS-CoV-2 (PASC) has shown inconsistent findings. This study aimed to generate coherent evidence the COVID-19 infection using electronic healthcare records across two regions.In this retrospective, multi-database cohort study, patients with aged 18 or above between April 1st 2020 and May 31st 2022 from Hong Kong Hospital Authority (HKHA) March 16th 2021 UK Biobank (UKB) databases their matched controls were followed for up 28 17 months, respectively. Covariates non-COVID-19 adjusted propensity score-based inverse probability treatment weighting. Cox proportional regression was used estimate hazard ratio (HR) clinical sequelae, cardiovascular, all-cause mortality 21 days after infection.A total 535,186 16,400 diagnosed HKHA UKB, whom 253,872 (47.4%) 7613 (46.4%) male, a mean age (±SD) 53.6 (17.8) years 65.0 (8.5) years, Patients incurred greater risk heart failure (HR 1.82; 95% CI 1.65, 2.01), atrial fibrillation (1.31; 1.16, 1.48), coronary artery disease (1.32; 1.07, 1.63), deep vein thrombosis (1.74; 1.27, 2.37), chronic pulmonary (1.61; 1.40, 1.85), acute respiratory distress syndrome (1.89; 1.04, 3.43), interstitial lung (3.91; 2.36, 6.50), seizure (2.32; 1.12, 4.79), anxiety disorder (1.65; 1.29, 2.09), post-traumatic stress (1.52; 1.23, 1.87), end-stage renal (1.76; 1.31, 2.38), kidney injury (2.14; 1.69, 2.71), pancreatitis (1.42; 1.10, 1.83), cardiovascular (2.86; 1.25, 6.51) (4.16; 2.11, 8.21) during phase infection.The consistent PASC highlighted need sustained multi-disciplinary care survivors.Health Bureau, The Government Special Administrative Region, Collaborative Research Fund, Region AIR@InnoHK, administered by Innovation Technology Commission, Region.

Language: Английский

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Post COVID-19 condition, work ability and occupational changes in a population-based cohort

The Lancet Regional Health - Europe, Journal Year: 2023, Volume and Issue: 31, P. 100671 - 100671

Published: June 25, 2023

Evidence on the impact of post COVID-19 condition (PCC) work ability is limited but critical due to its high prevalence among working-age individuals. This study aimed evaluate association between PCC, ability, and occupational changes in a population-based cohort.We used data from adults included prospective, longitudinal cohort random sample all individuals infected with SARS-CoV-2 August 2020 January 2021 Canton Zurich, Switzerland. We evaluated current related physical mental demands, estimated future 2 years (assessed using Work Ability Index), PCC-related one year after infection.Of 672 this study, 120 (17.9%) were categorised as having PCC (defined presence self-reported symptoms) at 12 months. There was very strong evidence that scores mean 0.62 (95% CI 0.30-0.95) points lower those compared without adjusted regression analyses. Similarly, there for odds reporting higher respect (adjusted ratio (aOR) 0.30, 95% 0.20-0.46) (aOR 0.40, 0.27-0.62) demands PCC. Higher age history psychiatric diagnosis associated more substantial reductions ability. 5.8% reported direct effects their situation, 1.6% completely dropping out workforce.These findings highlight need providing support interdisciplinary interventions affected by help them maintain or regain productivity.Federal Office Public Health, Department Health University Zurich Foundation, Switzerland; Horizon Europe.

Language: Английский

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Post-Acute Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection by Viral Variant and Vaccination Status: A Multicenter Cross-Sectional Study

Clinical Infectious Diseases, Journal Year: 2023, Volume and Issue: 77(2), P. 194 - 202

Published: March 11, 2023

Disentangling the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and vaccination on occurrence post-acute sequelae SARS-CoV-2 (PASC) is crucial to estimate reduce burden PASC.We performed a cross-sectional analysis (May/June 2022) within prospective multicenter healthcare worker (HCW) cohort in north-eastern Switzerland. HCWs were stratified by viral variant status at time their first positive nasopharyngeal swab. without swab with negative serology served as controls. The sum 18 self-reported PASC symptoms was modeled univariable multivariable negative-binomial regression analyze association mean symptom number status.Among 2912 participants (median age: 44 years; 81.3% female), significantly more frequent after wild-type infection (estimated number: 1.12; P < .001; median since infection: 18.3 months), Alpha/Delta (0.67 symptoms; 6.5 Omicron BA.1 infections (0.52 = .005; 3.1 months) versus uninfected controls (0.39 symptoms). After infection, estimated 0.36 for unvaccinated individuals 0.71 1-2 vaccinations (P .028) 0.49 ≥3 prior .30). Adjusting confounders, only (adjusted rate ratio [aRR]: 2.81; 95% confidence interval [CI]: 2.08-3.83) (aRR: 1.93; CI: 1.10-3.46) associated outcome.Previous pre-Omicron strongest risk factor among our HCWs. Vaccination before not clear protective effect against this population.

Language: Английский

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Post-COVID syndrome prevalence: a systematic review and meta-analysis

BMC Public Health, Journal Year: 2024, Volume and Issue: 24(1)

Published: July 4, 2024

Abstract Background Since the Coronavirus disease 2019 (COVID-19) pandemic began, number of individuals recovering from COVID-19 infection have increased. Post-COVID Syndrome, or PCS, which is defined as signs and symptoms that develop during after in line with COVID-19, continue beyond 12 weeks, are not explained by an alternative diagnosis, has also gained attention. We systematically reviewed determined pooled prevalence estimate PCS worldwide based on published literature. Methods Relevant articles Web Science, Scopus, PubMed, Cochrane Library, Ovid MEDLINE databases were screened using a Preferred Reporting Items for Systematic Reviews Meta-Analyses-guided systematic search process. The included studies English, January 2020 to April 2024, had overall one outcomes studied, involved human population confirmed diagnosis undergone assessment at weeks post-COVID beyond. As primary outcome measured, was estimated meta-analysis data extracted individual studies, conducted via random-effects model. This study been registered PROSPERO (CRD42023435280). Results Forty eight met eligibility criteria this review. 16 accepted worldwide, 41.79% (95% confidence interval [CI] 39.70–43.88%, I 2 = 51%, p 0.03). Based different follow-up timepoints acute infection, ≥ 3rd, 6th, 12th months each 45.06% CI: 41.25–48.87%), 41.30% 34.37–48.24%), 41.32% 39.27–43.37%), respectively. Sex-stratified 47.23% 44.03–50.42%) male 52.77% 49.58–55.97%) female. continental regions, 46.28% 39.53%-53.03%) Europe, 46.29% 35.82%-56.77%) America, 49.79% 30.05%-69.54%) Asia, 42.41% 0.00%-90.06%) Australia. Conclusion estimates could be used further comprehensive might enable development better management plans reduce effect health related economic burden.

Language: Английский

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Prevalence of mental health conditions and brain fog in people with long COVID: A systematic review and meta-analysis

General Hospital Psychiatry, Journal Year: 2024, Volume and Issue: 88, P. 10 - 22

Published: Feb. 27, 2024

Long COVID can include impaired cognition ('brain fog'; a term encompassing multiple symptoms) and mental health conditions. We performed systematic review meta-analysis to estimate their prevalence explore relevant factors associated with the incidence of Searches were conducted in Medline PsycINFO cover start pandemic until August 2023. Included studies reported conditions brain fog adults long after clinically-diagnosed or PCR-confirmed SARS-CoV-2 infection. 17 included, reporting 41,249 patients. Across all timepoints(3–24 months), combined was 20·4%(95% CI 11·1%-34·4%), being lower among those previously hospitalised than community-managed patients(19·5 vs 29·7% respectively; p = 0·047). The odds increased over time when validated instruments used. Odds significantly decreased increasing vaccination rates (p ·000). Given time, preventive interventions treatments are needed. Research is needed underlying mechanisms that could inform further research development effective treatments. reduced risk emphasizes need for ongoing programs.

Language: Английский

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Persistent symptoms and clinical findings in adults with post-acute sequelae of COVID-19/post-COVID-19 syndrome in the second year after acute infection: A population-based, nested case-control study

PLoS Medicine, Journal Year: 2025, Volume and Issue: 22(1), P. e1004511 - e1004511

Published: Jan. 23, 2025

Background Self-reported health problems following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are common and often include relatively non-specific complaints such as fatigue, exertional dyspnoea, concentration or memory disturbance sleep problems. The long-term prognosis of post-acute sequelae COVID-19/post-COVID-19 (PCS) is unknown, data finding correlating organ dysfunction pathology with self-reported symptoms in patients non-recovery from PCS scarce. We wanted to describe clinical characteristics diagnostic findings among persisting for >1 year assessed risk factors persistence versus improvement. Methods This nested population-based case-control study included subjects aged 18–65 years ( n = 982) age- sex-matched control without 576) according an earlier questionnaire (6–12 months after infection, phase 1) consenting provide follow-up information undergo comprehensive outpatient assessment, including neurocognitive, cardiopulmonary exercise, laboratory testing four university centres southwestern Germany (phase 2, another 8.5 [median, range 3–14 months] 1). mean age the participants was 48 years, 65% were female. At 67.6% at 1 developed persistent PCS, whereas 78.5% recovered remained free related PCS. Improvement associated mild index previous full-time employment, educational status, no specialist consultation not attending a rehabilitation programme. development new initially intercurrent secondary SARS-CoV-2 status. Patients less frequently never smokers (61.2% 75.7%), more obese (30.2% 12.4%) higher values body mass (BMI) fat, had lower status (university entrance qualification 38.7% 61.5%) than continued recovery. Fatigue/exhaustion, neurocognitive disturbance, chest symptoms/breathlessness anxiety/depression/sleep predominant symptom clusters. Exercise intolerance post-exertional malaise (PEM) >14 h compatible myalgic encephalomyelitis/chronic fatigue reported by 35.6% 11.6% patients, respectively. In analyses adjusted sex-age class combinations, centre qualification, significant differences between those recovery observed performance three different tests, scores perceived stress, subjective cognitive disturbances, dysautonomia, depression anxiety, quality, quality life. handgrip strength (40.2 [95% confidence interval (CI) [39.4, 41.1]] 42.5 CI [41.5, 43.6]] kg), maximal oxygen consumption (27.9 [27.3, 28.4]] 31.0 [30.3, 31.6]] ml/min/kg weight) ventilatory efficiency (minute ventilation/carbon dioxide production slope, 28.8 [28.3, 29.2]] 27.1 [26.6, 27.7]]) significantly reduced relative group adjustment centre, education, BMI, smoking use beta blocking agents. There measures systolic diastolic cardiac function rest, level N-terminal brain natriuretic peptide blood levels other measurements (including complement activity, markers Epstein–Barr virus [EBV] reactivation, inflammatory coagulation markers, serum cortisol, adrenocorticotropic hormone dehydroepiandrosterone sulfate). Screening viral (PCR stool samples spike antigen plasma) subgroup negative. Sensitivity (pre-existing illness/comorbidity, obesity, medical care infection) revealed similar findings. PEM pain worse results almost all tests. A limitation that we objective on exercise capacity cognition before infection. addition, did unable attend clinic whatever reason illness, immobility social deprivation exclusion. Conclusions this study, majority working recover second their illness. Patterns essentially similar, dominated complaints. Despite signs deficits capacity, there major investigations, our do support persistence, EBV adrenal insufficiency increased turnover pathophysiologically relevant history disease might help stratify cases severity.

Language: Английский

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Long COVID or Post-COVID-19 Condition: Past, Present and Future Research Directions

Microorganisms, Journal Year: 2023, Volume and Issue: 11(12), P. 2959 - 2959

Published: Dec. 11, 2023

The presence of symptoms after an acute SARS-CoV-2 infection (long-COVID) has become a worldwide healthcare emergency but remains underestimated and undertreated due to lack recognition the condition knowledge underlying mechanisms. In fact, prevalence post-COVID ranges from 50% during first months up 20% two-years after. This perspective review aimed map existing literature on identify gaps in guide global effort toward improved understanding long-COVID suggest future research directions. There is plethora symptomatology that can be COVID-19; however, today, there no clear classification definition this condition, termed or post-COVID-19 condition. heterogeneity led groups/clusters patients, which could exhibit different risk factors Viral persistence, long-lasting inflammation, immune dysregulation, autoimmune reactions, reactivation latent infections, endothelial dysfunction alteration gut microbiota have been proposed as potential mechanisms explaining complexity long-COVID. such equation, viral biology (e.g., re-infections, variants), host genetics, epigenetics) external vaccination) should also considered. These various will discussed current directions suggested.

Language: Английский

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Prevalence and risk factors of long COVID 6–12 months after infection with the Omicron variant among nonhospitalized patients in Hong Kong

Journal of Medical Virology, Journal Year: 2023, Volume and Issue: 95(6)

Published: June 1, 2023

Abstract Long COVID has been reported among patients with COVID‐19, but little is known about the prevalence and risk factors associated long 6–12 months after infection Omicron variant. This a large‐scale retrospective study. A total of 6242 out 12 950 nonhospitalized subjects all ages SARS‐CoV‐2 (confirmed by polymerase chain reaction/rapid antigen test) during dominant outbreak (December 31, 2021–May 6, 2022) in Hong Kong were included. Prevalence COVID, frequencies symptoms, analyzed. Three thousand four hundred thirty (55.0%) at least one symptom. The most symptom was fatigue (1241, 36.2%). Female gender, middle age, obesity, comorbidities, vaccination infection, having more presenting fatigue/chest tightness/headache/diarrhea acute stage illness identified as for COVID. Patients who had received three or doses vaccine not lower (adjusted odds ratio 1.105, 95% confidence interval 0.985–1.239, p = 0.088). Among vaccine, there no significant difference between CoronaVac BNT162b2 ( > 0.05). can lead to proportion infection. Further investigation needed uncover mechanisms underlying development determine impact various such vaccines.

Language: Английский

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Musculoskeletal involvement: COVID-19 and post COVID 19

Turkish Journal of Physical Medicine and Rehabilitation, Journal Year: 2023, Volume and Issue: 1(1), P. 1 - 7

Published: Feb. 28, 2023

The worldwide pandemic of coronavirus disease 2019 (COVID-19) was known to predominantly affect the lungs, but it realized that COVID-19 had a large variety clinical involvement. Cardiovascular, gastrointestinal, neurological, and musculoskeletal systems are involved by direct or indirect mechanisms with various manifestations. involvement can manifest during infection, due medications used for treatment COVID-19, in post/long syndrome. major symptoms fatigue, myalgia/arthralgia, back pain, low chest pain. During last two years, increased, no clear consensus obtained about pathogenesis. However, there is valuable data supports hypothesis angiotensinconverting enzyme 2, inflammation, hypoxia, muscle catabolism. Additionally, were also have adverse effects, such as corticosteroid-induced myopathy osteoporosis. Therefore, while deciding drugs, priorities benefits should be taken into consideration. Symptoms begin three months from onset continue at least months, cannot explained another diagnosis accepted Prior may persist fluctuate, new manifest. In addition, must one symptom infection. Most common myalgia, arthralgia, weakness, sarcopenia, impaired exercise capacity, physical performance. female sex, obesity, elderly patients, hospitalization, prolonged immobility, having mechanical ventilation, not vaccination, comorbid disorders predictors Musculoskeletal pain problem tends chronic form. There on mechanism, inflammation angiotensin-converting 2 seem play an important role. Localized generalized occur after general localized An accurate allows physicians initiate management proper rehabilitation programs.

Language: Английский

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