Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2

Antonelli, Michela; Pujol, Joan Capdevila; Spector, Tim D.; Ourselin, Sébastien; Steves, Claire J.

doi:10.1016/s0140-6736(22)00941-2

Cited by 469 publications

(438 citation statements)

References 3 publications

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“…Currently, Omicron variant is the dominant variant with enhanced transmissibility since February 2022, replacing Delta variant that was most prominent in 2021. A recent study showed that Omicron variant caused lower risk in developing long COVID in comparison to Delta variant among infected patients [84]. The finding is probably associated with the fact that Omicron variant generally caused less severe symptoms than Delta variant at Acute stage.…”

Section: The Severity Of Acute Covid Infectionmentioning

confidence: 96%

Long COVID and its Management

Koc¹,

Xiao²,

Liu³

et al. 2022

Int. J. Biol. Sci.

163

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The pandemic of COVID-19 is the biggest public health crisis in 21 st Century. Besides the acute symptoms after infection, patients and society are also being challenged by the long-term health complications associated with COVID-19, commonly known as long COVID. While health professionals work hard to find proper treatments, large amount of knowledge has been accumulated in recent years. In order to deal with long COVID efficiently, it is important for people to keep up with current progresses and take proactive actions on long COVID. For this purpose, this review will first introduce the general background of long COVID, and then discuss its risk factors, diagnostic indicators and management strategies. This review will serve as a useful resource for people to understand and prepare for long COVID that will be with us in the foreseeable future.

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Section: The Severity Of Acute Covid Infectionmentioning

confidence: 96%

Long COVID and its Management

Koc¹,

Xiao²,

Liu³

et al. 2022

Int. J. Biol. Sci.

163

View full text Add to dashboard Cite

show abstract

“…UK Office for National Statistics data shows Omicron variant has caused the greatest number of COVID and long COVID cases in the UK (21). But a new analysis that compared delta and omicron periods in the UK shows long COVID prevalence is twice as less in omicron variant waves and omicron cases were less likely to experience long COVID even with more than 6 months gap between vaccination and infection (OR 0.24 to 0.50 (22). Mapping long COVID data with all the different subvariants of SARS-CoV-2 will also help inform the public health measures against the pandemic spread.…”

Section: Unanswered Questions and Future Researchmentioning

confidence: 99%

Impact of COVID-19 vaccination on long COVID: a systematic review and meta-analysis

Byambasuren

Stehlik

Clark

et al. 2022

Preprint

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Background: The impact of COVID-19 vaccination on preventing or treating long COVID is unclear. We aim to assess the impact of COVID vaccinations administered (i) before and (ii) after acute COVID-19, including vaccination after long COVID diagnosis, on the rates or symptoms of long COVID. Methods: We searched PubMed, Embase, Cochrane COVID-19 trials, and Europe PMC for preprints from 1 Jan 2020 to 16 Feb 2022. We included trials, cohort, and case control studies reporting on long COVID cases and symptoms with vaccine administration both before and after COVID-19 diagnosis as well as after long COVID diagnosis. Risk of bias was assessed using ROBINS-I. Results: We screened 356 articles and found no trials, but 6 observational studies from 3 countries (USA, UK, France) that reported on 442,601 patients. The most common long COVID symptoms studied include fatigue, cough, loss of smell, shortness of breath, loss of taste, headache, muscle ache, trouble sleeping, difficulty concentrating, worry or anxiety, and memory loss or confusion. Four studies reported data on vaccination before SARS-CoV-2 infection, of which three showed statistically significant reduction in long COVID: the odds ratio of developing long COVID with one dose of vaccine ranged between OR 0.22 to 1.03; with two doses OR 0.51 to 1; and with any dose OR 0.85 to 1.01. Three studies reported on post-infection vaccination with odds ratios between 0.38 to 0.91. The high heterogeneity between studies precluded any meaningful meta-analysis. Studies failed to adjust for potential confounders such as other protective behaviours, and missing data, thus increasing the risk of bias, and decreasing the certainty of evidence to low. Discussion: Current studies suggest that COVID-19 vaccinations may have protective and therapeutic effects on long COVID. However, more robust comparative observational studies and trials are urgently needed to clearly determine effectiveness of vaccines in prevention and treatment of long COVID.

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“…Fourth, Zurich SARS-CoV-2 Cohort participants were enrolled when wildtype SARS-CoV-2 was the predominant circulating strain and prior to vaccination. Further research is needed to assess the effect of vaccination (34,35) or infection with emerging strains (e.g., Delta and Omicron) (36) on the development and persistence of post COVID-19 condition. Fifth, selection bias may have occurred if individuals who were more concerned with their health were more likely to participate, or if individuals with post COVID-19 condition were more likely to be retained in the study.…”

Section: Limitationsmentioning

confidence: 99%

Natural course of post COVID-19 condition and implications for trial design and outcome selection: A population-based longitudinal cohort study

Menges

Anagnostopoulos

Domenghino

et al. 2022

Preprint

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Background: Evidence from population-based studies on the longer-term natural course of post COVID-19 condition is limited, but crucial for informing patients and healthcare providers and for effectively designing clinical trials. Objectives: To evaluate longer-term symptoms and health outcomes within a cohort of SARS-CoV-2 infected individuals. Design: Population-based, longitudinal cohort. Setting: General population, Canton of Zurich, Switzerland. Patients: 1543 adults with confirmed SARS-CoV-2 infection and 628 adults without infection. Measurements: Changes in self-reported health status over time, factors associated with persistence of non-recovery, and prevalence and excess risk of symptoms at 6 and 12 months post-infection compared to non-infected individuals. Results: 25% of SARS-CoV-2 infected individuals did not recover by 6 months. Of those, 67% and 58% also did not recover at 12 and 18 months after infection, respectively. Hospitalization for acute COVID-19, pre-existing fatigue and pain or discomfort, and presence of specific systemic, cardiovascular, or musculoskeletal symptoms at 6 months were associated with persistent non-recovery. Symptom prevalence was higher among infected individuals compared to non-infected individuals at 6 months (adjusted risk difference (aRD)=17%) and 12 months (aRD=20%). aRDs for individual symptoms ranged from 2% to 12%, with the highest excess risks observed for altered taste or smell, post-exertional malaise, fatigue, and reduced concentration and memory. Limitations: We relied on self-reported assessments and did not assess the effects of vaccination or infection with emerging variants of concern. Conclusion: These findings emphasize the need for effective interventions to reduce the burden of post COVID-19 condition. They further demonstrate the importance of using multiple outcome measures and of considering the expected rates of natural recovery and heterogenous patient trajectories in the design and interpretation of clinical trials.

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Risk of long COVID associated with delta versus omicron variants of SARS-CoV-2

Cited by 469 publications

References 3 publications

Long COVID and its Management

Long COVID and its Management

Impact of COVID-19 vaccination on long COVID: a systematic review and meta-analysis

Natural course of post COVID-19 condition and implications for trial design and outcome selection: A population-based longitudinal cohort study

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