Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection

Frontiers in Medicine

Medicine

Jerry A. Krishnan¹  James N. Moy²  Mujeeb Basit³  Ivan O. Rosas⁴  Victor F. Tapson⁵  Mirella Salvatore⁶  Bellur S. Prabhakar⁷  Sairam Parthasarathy⁸  Christopher R. deFilippi⁹  William A. Conrad^1,10  Vanessa K. Ridaura^1,11  Chen Chen^1,11  Jacqueline M. Leung^1,11  Howard C. Zisser^1,11  Charles C. Kim^1,11  Michelle J. Wu^1,11  Katherine A. Drake^1,11 

[1] Breathe Chicago Center, University of Illinois Chicago, Chicago, IL, United States;Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States;Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States;Department of Medicine, Baylor College of Medicine, Houston, TX, United States;Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States;Department of Medicine, Weill Cornell Medicine, New York, NY, United States;Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States;Department of Microbiology and Immunology, University of Illinois–College of Medicine, Chicago, IL, United States;Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, United States;Inova Heart and Vascular Institute, Falls Church, VA, United States;Providence Little Company of Mary Medical Center Torrance, Torrance, CA, United States;Verily Life Sciences, South San Francisco, CA, United States;

关键词: PASC;    symptom clusters;    long COVID;    SARS-CoV-2;    COVID-19;   

DOI  :  10.3389/fmed.2023.1227883

 received in 2023-05-23, accepted in 2023-09-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe understanding of Post-acute sequelae of SARS-CoV-2 infection (PASC) can be improved by longitudinal assessment of symptoms encompassing the acute illness period. To gain insight into the various disease trajectories of PASC, we assessed symptom evolution and clinical factors associated with the development of PASC over 3 months, starting with the acute illness period.MethodsWe conducted a prospective cohort study to identify parameters associated with PASC. We performed cluster and case control analyses of clinical data, including symptomatology collected over 3 months following infection.ResultsWe identified three phenotypic clusters associated with PASC that could be characterized as remittent, persistent, or incident based on the 3-month change in symptom number compared to study entry: remittent (median; min, max: −4; −17, 3), persistent (−2; −14, 7), or incident (4.5; −5, 17) (p = 0.041 remittent vs. persistent, p < 0.001 remittent vs. incident, p < 0.001 persistent vs. incident). Despite younger age and lower hospitalization rates, the incident phenotype had a greater number of symptoms (15; 8, 24) and a higher proportion of participants with PASC (63.2%) than the persistent (6; 2, 9 and 52.2%) or remittent clusters (1; 0, 6 and 18.7%). Systemic corticosteroid administration during acute infection was also associated with PASC at 3 months [OR (95% CI): 2.23 (1.14, 4.36)].ConclusionAn incident disease phenotype characterized by symptoms that were absent during acute illness and the observed association with high dose steroids during acute illness have potential critical implications for preventing PASC.

【 授权许可】

Unknown   
Copyright © 2023 Chen, Parthasarathy, Leung, Wu, Drake, Ridaura, Zisser, Conrad, Tapson, Moy, deFilippi, Rosas, Prabhakar, Basit, Salvatore, Krishnan and Kim.