Abstract:Coronavirus disease 2019 (COVID‐19) is spreading worldwide; there is a need to address its sequelae known as Long COVID. This study evaluated postvaccination changes in symptoms and antibody titers in patients with Long COVID. Patients visiting the outpatient department specializing in Long COVID at our hospital were enrolled. Changes in symptoms were evaluated before and 14–21 days after first vaccination. Antibody titers were measured using ARCHITECT SARS‐CoV‐2 IgG II Quant at the same time. This study inclu… Show more
“…A total of 13 published and 8 preprint full-text articles were assessed for eligibility 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ( Figure 1 ). Two articles were excluded because they were government summary reports.…”
Section: Resultsmentioning
confidence: 99%
“… 23 Finally, a total of 11 peer-reviewed studies and 6 preprints were included in the systematic review. 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flow diagram. …”
Section: Resultsmentioning
confidence: 99%
“…The characteristics of the ‘infection - long COVID - vaccine’ studies are shown in Table 2 , involving 36,736 COVID-19 survivors and encompassing eleven papers. 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 With respect to the geographical distribution, four articles were from the UK, two from the USA, one each from France, Italy, Israel, Japan, and Switzerland. Three out of 11 articles 26 , 32 , 33 gathered data on mRNA vaccines only, seven articles 25 , 27 , 29 , 30 , 31 , 34 , 35 on mRNA and viral vector vaccines, while one article 28 did not mention the type of vaccine.…”
Section: Resultsmentioning
confidence: 99%
“…25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 With respect to the geographical distribution, four articles were from the UK, two from the USA, one each from France, Italy, Israel, Japan, and Switzerland. Three out of 11 articles 26 , 32 , 33 gathered data on mRNA vaccines only, seven articles 25 , 27 , 29 , 30 , 31 , 34 , 35 on mRNA and viral vector vaccines, while one article 28 did not mention the type of vaccine. All studies included patients with at least a single dose of vaccine.…”
“…A total of 13 published and 8 preprint full-text articles were assessed for eligibility 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ( Figure 1 ). Two articles were excluded because they were government summary reports.…”
Section: Resultsmentioning
confidence: 99%
“… 23 Finally, a total of 11 peer-reviewed studies and 6 preprints were included in the systematic review. 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flow diagram. …”
Section: Resultsmentioning
confidence: 99%
“…The characteristics of the ‘infection - long COVID - vaccine’ studies are shown in Table 2 , involving 36,736 COVID-19 survivors and encompassing eleven papers. 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 With respect to the geographical distribution, four articles were from the UK, two from the USA, one each from France, Italy, Israel, Japan, and Switzerland. Three out of 11 articles 26 , 32 , 33 gathered data on mRNA vaccines only, seven articles 25 , 27 , 29 , 30 , 31 , 34 , 35 on mRNA and viral vector vaccines, while one article 28 did not mention the type of vaccine.…”
Section: Resultsmentioning
confidence: 99%
“…25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 With respect to the geographical distribution, four articles were from the UK, two from the USA, one each from France, Italy, Israel, Japan, and Switzerland. Three out of 11 articles 26 , 32 , 33 gathered data on mRNA vaccines only, seven articles 25 , 27 , 29 , 30 , 31 , 34 , 35 on mRNA and viral vector vaccines, while one article 28 did not mention the type of vaccine. All studies included patients with at least a single dose of vaccine.…”
“…Results may not generalize to other variants of SARS-CoV-2 or populations with high prevalence of vaccination or re-infection, 59,60 although they may be more applicable as new variants evade current vaccine coverage, previous vaccine immunity wanes, and public health protections are removed. 61…”
ImportanceThe SARS-CoV-2 pandemic portends a significant increase in health care use related to post-acute COVID sequelae, but the magnitude is not known.ObjectiveTo assess the burden of post-acute health care use after a positive versus negative polymerase chain reaction (PCR) test for SARS-CoV-2.Design, Setting, and ParticipantsRetrospective cohort study of community-dwelling adults January 1, 2020 to March 31, 2021 in Ontario, Canada, using linked population-based health data. Follow-up began 56 days after PCR testing.ExposuresIndividuals with a positive SARS-CoV-2 PCR test were matched 1:1 to individuals who tested negative based on hospitalization, test date, public health unit, sex, and a propensity score of socio-demographic and clinical characteristics.Main Outcomes and MeasuresThe health care utilization rate was the number of outpatient clinical encounters, homecare encounters, emergency department visits, days hospitalized, and days in long-term care per person-year. Mean health care utilization for test-positive versus negative individuals was compared using negative binomial regression, and rates at 95th and 99th percentiles were compared. Outcomes were also stratified by sex.ResultsAmong 530,232 unique, matched individuals, mean age was 44 years (sd 17), 51% were female, and 0.6% had received ≥1 COVID-19 vaccine dose. The mean rate of health care utilization was 11% higher in test-positive individuals (RR 1.11, 95% confidence interval [CI] 1.10-1.13). At the 95th percentile, test-positive individuals had 2.1 (95% CI 1.5-2.6) more health care encounters per person-year, and at the 99th percentile 71.9 (95% CI 57.6-83.2) more health care encounters per person-year. At the 95th percentile, test-positive women had 3.8 (95% CI 2.8-4.8) more health care encounters per person-year while there was no difference for men. At the 99th percentile, test-positive women had 76.7 (95% CI 56.3-89.6) more encounters per person-year, compared to 37.6 (95% CI 16.7-64.3) per person-year for men.Conclusions and RelevancePost-acute health care utilization after a positive SARS-CoV-2 PCR test is significantly higher compared to matched test-negative individuals. Given the number of infections worldwide, this translates to a tremendous increase in use of health care resources. Stakeholders can use these findings to prepare for health care demand associated with long COVID.Key PointsQuestionHow does the burden of health care use ≥56 days after a positive SARS-CoV-2 polymerase chain reaction (PCR) test compare to matched individuals who tested negative?FindingsAfter accounting for multiple factors, the mean burden of post-acute health care use was 11% higher among those who tested positive, with higher rates of outpatient encounters, days hospitalized, and days in long-term care. Rates of homecare use were higher for test-positive women but lower for men.For perspective, for every day in January 2022 with 100,000 or more infections, this translates to an estimated 72,000 additional post-acute health care encounters per year for the 1% of people who experienced the most severe complications of SARS-CoV-2; among those in the top 50% of health care use, this translates to 245,000 additional health care encounters per year. This increase will occur in the context of an ongoing pandemic and, in many health care systems, a depleted workforce and backlogs of care. Unless addressed, this increase is likely to exacerbate existing health inequities.MeaningGiven the large number of people infected, stakeholders can use these findings to plan for health care use associated with long COVID.
Coronavirus disease 2019 (COVID‐19) is spreading worldwide; there is a need to address its sequelae known as Long COVID. This study evaluated postvaccination changes in symptoms and antibody titers in patients with Long COVID. Patients visiting the outpatient department specializing in Long COVID at our hospital were enrolled. Changes in symptoms were evaluated before and 14–21 days after first vaccination. Antibody titers were measured using ARCHITECT SARS‐CoV‐2 IgG II Quant at the same time. This study included 42 patients (median age: 45 years; 17 [40.5%] men). Median pre‐ and postvaccination antibody titers were 456 and 28,963 AU/ml, respectively. Postvaccination symptoms (fatigue, joint pain, and taste and olfactory abnormalities) were relieved, worsened, and unchanged in 7 (16.7%), 9 (21.4%), and 26 (61.9%) patients, respectively. Ratios of pre‐ and postvaccination antibody titers were 53, 40, and 174 in the unchanged, relief, and worsened groups, respectively. The worsened group had the significantly highest antibody titer ratio (
p
= 0.02). The higher increased rate of the antibody titer in the worsened group than in the nonworsened group suggests an excessive immune response to vaccination associated with worsening of sequelae. Although patients with Long COVID should be vaccinated, additional concerns should be addressed.
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