Cross-sectional study evaluating the impact of SARS-CoV-2 variants on Long COVID outcomes in UK hospital survivors

Saigal, Anita; Niklewicz, Camila Nagoda; Naidu, S. B.; Bintalib, Heba M.; Shah, AJ; Seligmann, George; Hunter, Alan; Wey, Emmanuel; Abubakar, Ibrahim; Mahungu, Tabitha; Molony, David; Barnett, Joseph; Jain, Nikhil; Brill, Simon; Goldring, James; Jarvis, Hannah; Smith, Colette; Ogbonnaya, Chibueze; Hurst, John R.; Lipman, Marc; Mandal, Swapna

doi:10.1136/bmjresp-2023-001667

Cited by 6 publications

(2 citation statements)

References 29 publications

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“…This study found that, compared to those who had no reported history of COVID-19 infection, or had recovered, those with long COVID had more severe symptoms of depression, anxiety, and psychological distress and reported more days out of role, indicating the functional impact of the symptoms. This is unsurprising given that a range of chronic conditions are known to be associated with poorer mental health outcomes, including those that also have the potential to increase people’s susceptibility to a severe COVID-19 infection, such as cardiovascular disease [ 25 , 26 , 27 ]. Also consistent with previous research, the patients reported cognitive difficulties, such as memory loss, confusion, and difficulty concentrating [ 28 ], and future research is planned to look at how digital mental health services can address the cognitive and mental health impacts of COVID-19 in both the short term and long term.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Predictors of Long COVID in Patients Accessing a National Digital Mental Health Service

Staples,

Nielssen,

Dear

et al. 2023

IJERPH

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MindSpot is a national mental health service that provides assessments and treatment to Australian adults online or via telephone. Since the start of 2020, questions related to the mental health impacts of COVID-19 have been routinely administered. The objective of the current study is to report the prevalence and predictors of self-reported “long COVID” in patients completing an assessment at the MindSpot Clinic between 5 September 2022 and 7 May 2023 (n = 17,909). Consistent with the World Health Organization definition, we defined long COVID as the occurrence of ongoing physical or mental health symptoms three months after a COVID-19 infection. We conducted a descriptive univariate analysis of patients who reported: no COVID-19 diagnosis (n = 6151); a current or recent (within 3 months) COVID-19 infection (n = 2417); no symptoms three months post-COVID-19 infection (n = 7468); or COVID-related symptoms at least three months post-infection (n = 1873). Multivariate logistic regression was then used to compare patients with and without symptoms three months post-COVID to identify potential predictors for long COVID. The prevalence of long COVID was 10% of the total sample (1873/17909). Patients reporting symptoms associated with long COVID were older, more likely to be female, and more likely to be depressed and report a reduced ability to perform their usual tasks. Sociodemographic factors, including cultural background, education, and employment, were examined. These results provide evidence of the significant prevalence of symptoms of long COVID in people using a national digital mental health service. Reporting outcomes in an Australian context and in specific sub-populations is important for public health planning and for supporting patients.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Predictors of Long COVID in Patients Accessing a National Digital Mental Health Service

Staples,

Nielssen,

Dear

et al. 2023

IJERPH

View full text Add to dashboard Cite

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“…Several studies representing a range of global regions have investigated the likelihood of developing long-term sequelae following COVID-19 infection according to variant of infection, with studies consistently finding a lower likelihood of long-term sequelae following infections with the Omicron variant compared to the ancestral Wild Type strain or subsequent variants of concern (VoCs) (9–20). There is some evidence that Wild Type infections were associated with a greater likelihood of developing long-term sequelae compared to subsequent variants (9,12,16,21), though between-variant differences prior to Omicron are less consistent across studies. However, current understanding of the impact of SARS-CoV-2 variant on likelihood of post-acute sequelae are impacted by several methodological concerns.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of SARS-CoV-2 Variants and Other Respiratory Infections: Evidence from the Virus Watch Prospective Cohort in England

Beale,

Yavlinsky,

Fong

et al. 2023

Preprint

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BackgroundGiven the considerable prevalence of long-term sequelae following SARS-CoV-2 infection, understanding pathogen-related factors that influence long-term outcomes is warranted. We aimed to compare the likelihood of long-term symptoms for SARS-CoV-2 variants, other acute respiratory infections (ARIs) and non-infected individuals.MethodData were from 5,630 individuals participating in Virus Watch, a prospective community cohort study of SARS-CoV-2 epidemiology in England. We used logistic regression to compare the predicted probability of developing long-term symptoms (>2 months duration) during different variant dominance periods according to infection status (SARS-CoV-2, other ARI, or no infection), adjusting for confounding by demographic and clinical factors and vaccination status.ResultsPredicted probability of long-term sequelae was greater following SARS-CoV-2 infection during the Wild Type (adjusted predicted probability (PP) 0.28, 95% confidence interval (CI) =0.14-0.43), Alpha (PP= 0.28, 95% CI =0.14-0.42), Delta (PP= 0.34, 95% CI=0.25-0.43) and Omicron BA.1 periods (PP= 0.27, 95% CI =0.22-0.33) compared to later Omicron sub-variants (PP range from 0.11, 95% CI 0.08-0.15 to 0.14, 95% CI 0.10-0.18). While differences between SARS-CoV-2 and other ARIs (PP range 0.08, 95% CI 0.04-0.11 to 0.23, 95% CI 0.18-0.28) varied by period, estimates for long-term symptoms following both infection types substantially exceeded those for non-infected participants (PP range 0.01, 95% CI 0.00,0.02 to 0.03, 95% CI 0.01-0.06) across all variant periods.ConclusionsBetween-variant differences influenced the likelihood of post-infection sequelae for SARS-CoV-2, with lower predicted probabilities for recent Omicron sub-variants similar to those for other contemporaneous ARIs. Both SARS-CoV-2 and other ARIs were associated with long-term symptom development, and further aetiological investigation including between-pathogen comparison is recommended.

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Long COVID across SARS‐CoV‐2 variants: Clinical features, pathogenesis, and future directions

Lok,

Sarkar,

Lam

et al. 2024

MedComm – Future Medicine

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Long coronavirus disease (COVID) is characterized by persistent symptoms following severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and has emerged as a significant health concern. As SARS‐CoV‐2 evolved from the wild‐type strain to the Alpha, Beta, Delta, and Omicron variants, there may be a variant‐specific influence on long COVID akin to the acute disease. This review aims to summarize our current knowledge of variant‐specific influences in long COVID incidence, symptom profile as well as mechanisms of pathogenesis. We highlight that long COVID incidence may be lower with the Omicron variants. The symptom profile of long COVID may also show some dependence on the different variants, with a reduction in cardiopulmonary symptoms with more recent SARS‐CoV‐2 variants. This heterogeneity of long COVID may also be related to the variant‐specific differences in affecting the immune system, viral persistence, and autoimmunity. However, emerging data also suggest that vaccinations may play a big role in shaping the presentation of long COVID. We also highlight ongoing work on long COVID incidence and symptom profiles in populations infected only by the Omicron variants. This will be beneficial toward more useful disease definitions and the development of effective diagnostic and therapeutic strategies.

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Cross-sectional study evaluating the impact of SARS-CoV-2 variants on Long COVID outcomes in UK hospital survivors

Cited by 6 publications

References 29 publications

Prevalence and Predictors of Long COVID in Patients Accessing a National Digital Mental Health Service

Prevalence and Predictors of Long COVID in Patients Accessing a National Digital Mental Health Service

Long-Term Outcomes of SARS-CoV-2 Variants and Other Respiratory Infections: Evidence from the Virus Watch Prospective Cohort in England

Long COVID across SARS‐CoV‐2 variants: Clinical features, pathogenesis, and future directions

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