SARS-CoV-2 infection outcomes associated with the Delta variant: A prospective cohort study

Gallant, Maxime A.; Rioux-Perreault, Christine; Lemaire-Paquette, Samuel; Piché, Alain

doi:10.3138/jammi-2022-0022

“…The prevalence of PCC in our study population was 48%. That proportion is congruent with other studies [ 10 , 21 , 22 , 23 , 24 ]. Describing functional impacts in patients with PCC is essential since it could affect the burden of their condition.…”

Section: Discussionsupporting

confidence: 92%

“…We also explored factors that can predict the occurrence of PCC. Consistent with other studies, we found that the numbers of symptoms at onset is the main predictor of PCC [ 22 , 23 ]. We also observed that participants with PCC without fatigue showed a higher prevalence of comorbidities and higher number of symptoms at onset.…”

Section: Discussionsupporting

confidence: 92%

Long-Term Consequences of COVID-19 in Predominantly Immunonaive Patients: A Canadian Prospective Population-Based Study

Benoit-Piau,

Tremblay,

Piché

et al. 2023

JCM

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Background: Lingering symptoms are frequently reported after acute SARS-CoV-2 infection, a condition known as post-COVID-19 condition (PCC). The duration and severity of PCC in immunologically naïve persons remain unclear. Furthermore, the long-term consequences of these chronic symptoms on work and mental health are poorly documented. Objective: To determine the outcome, the risk factors, and the impact on work and mental health associated with post-COVID-19 symptoms. Methods: This prospective population-based study assessed acute COVID-19 symptoms and their evolution for up to nine months following infection. Individuals aged 18 years and older with COVID-19 in three Canadian regions between 1 November 2020 and 31 May 2021 were recruited. Participants completed a questionnaire that was either administered by trained student investigators over the phone or self-administered online. Results: A total of 1349 participants with a mean age of 46.6 ± 16.0 years completed the questionnaire. Participants were mostly unvaccinated at the time of their COVID-19 episode (86.9%). Six hundred and twenty-two participants (48.0%) exhibited one symptom or more, at least three months post-COVID-19. Among participants with PCC, 23.0% to 37.8% experienced fatigue at the time of survey. Moreover, 6.1% expressed psychological distress. Risk factors for PCC and fatigue included female sex (OR = 1.996), higher number of symptoms (OR = 1.292), higher severity of episode (OR = 3.831), and having a mental health condition prior to the COVID-19 episode (OR = 5.155). Conclusions: In this multicenter cohort study, almost half (47%) of the participants reported persistent symptoms >3 months after acute infection. Baseline risk factors for PCC include female sex, number and severity of symptoms during acute infection, and a previous diagnosis of mental health disorder. Having PCC negatively impacted health-related quality of life and these patients were more likely to exhibit psychological distress, as well as fatigue.

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“…In all PCC and No-PCC cases, the acute of disease was mild and none could be categorized as moderate or severe according to WHO criteria. However, the number of the symptoms reported at the acute disease was significantly higher in PCC groups than in No-PCC groups in both males (6 versus 4) and females (7 versus 5) (Mann Whitney test, males-No-PCC versus PCC, p=0.0035; females-No-PCC versus PCC, p<0.0001), in agreement with previous reports (Gallant et al, 2022a;Gallant et al, 2022b;Perlis et al, 2022;Sudre et al, 2021). Notably, in female PCC cases the number of comorbidities positively correlated with age, BMI and the number of PCC symptoms reported at 1-, 3and 6-months post-infection (Supplementary Figure S1, supplementary Table S4).…”

Section: Increased Prevalence Of Pcc Symptoms and Their Positive Corr...supporting

confidence: 91%

“…PCC encompasses a spectrum of clinical illnesses affecting multiple organs that persist for more than 3 months after the resolution of the initial infection (Nalbandian et al, 2021;Sudre et al, 2021;Sykes et al, 2021). It is estimated that 75-90% of SARS-CoV-2 infected individuals develop a mild COVID-19 disease and 5-50% percent of them develop symptoms of PCC for reasons that still remain unclear (Gallant et al, 2022b;Global Burden of Disease Long et al, 2022). Pre-existing co-morbidities, high level of SARS-CoV-2 viremia, presence of antibodies to type-I IFNs, reactivation of EBV or CMV-specific T cells during acute infection and anti-SARS-CoV-2 antibody signatures are some of the factors suggested to predict PCC in individuals with moderate to severe COVID-19 (Cervia et al, 2022;Peluso and Deeks, 2022;Su et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 spike antigen-specific B cell and antibody responses in pre-vaccination period COVID-19 convalescent males and females with or without post-covid condition

Limoges¹,

Quenum²,

Chowdhury³

et al. 2023

Preprint

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BackgroundFollowing SARS-CoV-2 infection a significant proportion of convalescent individuals develop the post-COVID condition (PCC) that is characterized by wide spectrum of symptoms encompassing various organs. Even though the underlying pathophysiology of PCC is not known, detection of viral transcripts and antigens in tissues other than lungs raise the possibility that PCC may be a consequence of aberrant immune response to the viral antigens. To test this hypothesis, we evaluated B cell and antibody responses to the SARS-CoV-2 antigens in PCC patients who experienced mild COVID-19 disease during the pre-vaccination period of COVID-19 pandemic.MethodsThe study subjects included unvaccinated male and female subjects who developed PCC or not (No-PCC) after clearing RT-PCR confirmed mild COVID-19 infection. SARS-CoV-2 D614G and omicron RBD specific B cell subsets in peripheral circulation were assessed by flow cytometry. IgG, IgG3 and IgA antibody titers toward RBD, spike and nucleocapsid antigens in the plasma were evaluated by ELISA.ResultsThe frequency of the B cells specific to D614G-RBD were comparable in convalescent groups with and without PCC in both males and females. Notably, in females with PCC, the anti-D614G RBD specific double negative (IgD-CD27-) B cells showed significant correlation with the number of symptoms at acute of infection. Anti-spike antibody responses were also higher at 3 months post-infection in females who developed PCC, but not in the male PCC group. On the other hand, the male PCC group also showed consistently high anti-RBD IgG responses compared to all other groups.ConclusionsThe antibody responses to the spike protein, but not the RBD-specific B cell responses diverge between convalescent males and females, and those who develop PCC or not. Our findings suggest that sex-related factors may also be involved in the development of PCC via modulating antibody responses to the SARS-CoV-2 antigens.Short SummaryPost-COVID Condition (PCC) is lingering illness that afflicts a significant proportion of COVID-19 patients from three months after clearing SARS-CoV-2 infection. Therapy for PCC is only palliative and the underlying disease mechanisms are unclear. The wide spectrum of PCC symptoms that can affect different organs and the detection of viral components in tissues distant from lungs raise the possibility that PCC may be associated with aberrant immune response due to presence of viral antigens. Therefore, we studied B cell and antibody responses to the spike and nucleoprotein antigens in PCC patients who cleared mild SARS-CoV-2 infection during the pre-vaccination COVID-19 pandemic period. We observed divergent patterns of immune reactivity to the spike protein in PCC males and females at different times post-infection, suggesting that the immune responses in PCC may also be influenced by sex-related factors.

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“…PCC encompasses a spectrum of clinical illnesses affecting multiple organs that persist for more than 3 months after the resolution of the initial infection (5)(6)(7). It is estimated that 75-90% of SARS-CoV-2 infected individuals develop a mild COVID-19 disease and 5-50% percent of them develop symptoms of PCC for reasons that still remain unclear (8,9). Pre-existing co-morbidities, high level of SARS-CoV-2 viremia, presence of antibodies to type-I IFNs, reactivation of EBV or CMVspecific T cells during acute infection and anti-SARS-CoV-2 antibody signatures are some of the factors suggested to predict PCC in individuals with moderate to severe COVID-19 (10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 spike antigen-specific B cell and antibody responses in pre-vaccination period COVID-19 convalescent males and females with or without post-covid condition

Limoges,

Quenum,

Chowdhury

et al. 2023

Front. Immunol.

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0

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BackgroundFollowing SARS-CoV-2 infection a significant proportion of convalescent individuals develop the post-COVID condition (PCC) that is characterized by wide spectrum of symptoms encompassing various organs. Even though the underlying pathophysiology of PCC is not known, detection of viral transcripts and antigens in tissues other than lungs raise the possibility that PCC may be a consequence of aberrant immune response to the viral antigens. To test this hypothesis, we evaluated B cell and antibody responses to the SARS-CoV-2 antigens in PCC patients who experienced mild COVID-19 disease during the pre-vaccination period of COVID-19 pandemic.MethodsThe study subjects included unvaccinated male and female subjects who developed PCC or not (No-PCC) after clearing RT-PCR confirmed mild COVID-19 infection. SARS-CoV-2 D614G and omicron RBD specific B cell subsets in peripheral circulation were assessed by flow cytometry. IgG, IgG3 and IgA antibody titers toward RBD, spike and nucleocapsid antigens in the plasma were evaluated by ELISA.ResultsThe frequency of the B cells specific to D614G-RBD were comparable in convalescent groups with and without PCC in both males and females. Notably, in females with PCC, the anti-D614G RBD specific double negative (IgD-CD27-) B cells showed significant correlation with the number of symptoms at acute of infection. Anti-spike antibody responses were also higher at 3 months post-infection in females who developed PCC, but not in the male PCC group. On the other hand, the male PCC group also showed consistently high anti-RBD IgG responses compared to all other groups.ConclusionsThe antibody responses to the spike protein, but not the anti-RBD B cell responses diverge between convalescent males and females who develop PCC. Our findings also suggest that sex-related factors may also be involved in the development of PCC via modulating antibody responses to the SARS-CoV-2 antigens.

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SARS-CoV-2 infection outcomes associated with the Delta variant: A prospective cohort study

Cited by 5 publications

References 26 publications

Long-Term Consequences of COVID-19 in Predominantly Immunonaive Patients: A Canadian Prospective Population-Based Study

Long-Term Consequences of COVID-19 in Predominantly Immunonaive Patients: A Canadian Prospective Population-Based Study

SARS-CoV-2 spike antigen-specific B cell and antibody responses in pre-vaccination period COVID-19 convalescent males and females with or without post-covid condition

SARS-CoV-2 spike antigen-specific B cell and antibody responses in pre-vaccination period COVID-19 convalescent males and females with or without post-covid condition

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