15-month post-COVID syndrome in outpatients: Attributes, risk factors, outcomes, and vaccination status - longitudinal, observational, case-control study

Frontiers in Immunology

Immunology

Florian Klein¹  Dominic Rauschning²  Hauke Wüstenberg²  Michael Hallek²  Elisabeth Pracht²  Lea Katharina Picard³  Max Augustin⁴  Ute Sandaradura de Silva⁴  Clara Lehmann⁴  Philipp Schommers⁵  Melanie Stecher⁶  Christoph Wenisch⁷  Henning Gruell⁸  Veronica Di Cristanziano⁸ 

[1] Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;German Center for Infection Research [Deutsches Zentrum für Infektionsforschung (DZIF)], Cologne, Germany;Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;German Center for Infection Research [Deutsches Zentrum für Infektionsforschung (DZIF)], Cologne, Germany;Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;German Center for Infection Research [Deutsches Zentrum für Infektionsforschung (DZIF)], Cologne, Germany;Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;German Center for Infection Research [Deutsches Zentrum für Infektionsforschung (DZIF)], Cologne, Germany;Department IV of Internal Medicine, Klinik Favoriten, Vienna Healthcare Group, Vienna, Austria;Institute of Virology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany;

关键词: post-COVID syndrome;    PCS;    long COVID;    therapeutic vaccination;    symptom clusters;    outcome;    SARS-CoV-2 IgG;    recovery;   

DOI  :  10.3389/fimmu.2023.1226622

 received in 2023-05-21, accepted in 2023-08-22,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundWhile the short-term symptoms of post-COVID syndromes (PCS) are well-known, the long-term clinical characteristics, risk factors and outcomes of PCS remain unclear. Moreover, there is ongoing discussion about the effectiveness of post-infection vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) to aid in PCS recovery.MethodsIn this longitudinal and observational case-control study we aimed at identifying long-term PCS courses and evaluating the effects of post-infection vaccinations on PCS recovery. Individuals with initial mild COVID-19 were followed for a period of 15 months after primary infection. We assessed PCS outcomes, distinct symptom clusters (SC), and SARS-CoV-2 immunoglobulin G (IgG) levels in patients who received SARS-CoV-2 vaccination, as well as those who did not. To identify potential associating factors with PCS, we used binomial regression models and reported the results as odds ratios (OR) with 95% confidence intervals (95%CI).ResultsOut of 958 patients, follow-up data at 15 month after infection was obtained for 222 (23.2%) outpatients. Of those individuals, 36.5% (81/222) and 31.1% (69/222) were identified to have PCS at month 10 and 15, respectively. Fatigue and dyspnea (SC2) rather than anosmia and ageusia (SC1) constituted PCS at month 15. SARS-CoV-2 IgG levels were equally distributed over time among age groups, sex, and absence/presence of PCS. Of the 222 patients, 77.0% (171/222) were vaccinated between 10- and 15-months post-infection, but vaccination did not affect PCS recovery at month 15. 26.3% of unvaccinated and 25.8% of vaccinated outpatients improved from PCS (p= .9646). Baseline headache (SC4) and diarrhoea (SC5) were risk factors for PCS at months 10 and 15 (SC4: OR 1.85 (95%CI 1.04-3.26), p=.0390; SC5: OR 3.27(95%CI 1.54-6.64), p=.0009).ConclusionBased on the specific symptoms of PCS our findings show a shift in the pattern of recovery. We found no effect of SARS-CoV-2 vaccination on PCS recovery and recommend further studies to identify predicting biomarkers and targeted PCS therapeutics.

【 授权许可】

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Copyright © 2023 Augustin, Stecher, Wüstenberg, Di Cristanziano, Sandaradura de Silva, Picard, Pracht, Rauschning, Gruell, Klein, Wenisch, Hallek, Schommers and Lehmann