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- Title
Mild antecedent COVID-19 associated with symptom-specific post-acute sequelae.
- Authors
Walker, Tiffany A.; Truong, Alex D.; Summers, Aerica; Dixit, Adviteeya N.; Goldstein, Felicia C.; Hajjar, Ihab; Echols, Melvin R.; Woodruff, Matthew C.; Lee, Erica D.; Tekwani, Seema; Carroll, Kelley; Sanz, Ignacio; Lee, F. Eun-Hyung; Han, Jenny E.
- Abstract
Background: The impact of COVID-19 severity on development of long-term sequelae remains unclear, and symptom courses are not well defined. Methods: This ambidirectional cohort study recruited adults with new or worsening symptoms lasting ≥3 weeks from confirmed SARS-CoV-2 infection between August 2020–December 2021. COVID-19 severity was defined as severe for those requiring hospitalization and mild for those not. Symptoms were collected using standardized questionnaires. Multivariable logistical regression estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between clinical variables and symptoms. Results: Of 332 participants enrolled, median age was 52 years (IQR 42–62), 233 (70%) were female, and 172 (52%) were African American. Antecedent COVID-19 was mild in 171 (52%) and severe in 161 (48%). In adjusted models relative to severe cases, mild COVID-19 was associated with greater odds of fatigue (OR:1.83, CI:1.01–3.31), subjective cognitive impairment (OR:2.76, CI:1.53–5.00), headaches (OR:2.15, CI:1.05–4.44), and dizziness (OR:2.41, CI:1.18–4.92). Remdesivir treatment was associated with less fatigue (OR:0.47, CI:0.26–0.86) and fewer participants scoring >1.5 SD on PROMIS Cognitive scales (OR:0.43, CI:0.20–0.92). Fatigue and subjective cognitive impairment prevalence was higher 3–6 months after COVID-19 and persisted (fatigue OR:3.29, CI:2.08–5.20; cognitive OR:2.62, CI:1.67–4.11). Headache was highest at 9–12 months (OR:5.80, CI:1.94–17.3). Conclusions: Mild antecedent COVID-19 was associated with highly prevalent symptoms, and those treated with remdesivir developed less fatigue and cognitive impairment. Sequelae had a delayed peak, ranging 3–12 months post infection, and many did not improve over time, underscoring the importance of targeted preventative measures.
- Subjects
COVID-19; DISEASE complications; FATIGUE (Physiology); CONFIDENCE intervals; COGNITION disorders
- Publication
PLoS ONE, 2023, Vol 18, Issue 7, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0288391