Symptoms compatible with long-COVID in healthcare workers with and without SARS-CoV-2 infection – results of a prospective multicenter cohort

Strahm, Carol; Seneghini, Marco; Guesewell, Sabine; Egger, Thomas; Neto, Onicio Batista Leal; Brucher, Angela; Lemmenmaier, Eva; Kleeb, Dorette Meier; Moeller, Carsten; Rieder, Peter; Ruetti, Markus; Rutz, Remus; Schmid, H. H.; Stocker, Reto; Vuichard-Gysin, Danelle; Wiggli, Benedikt; Besold, Ulrike; Kuster, Stefan P.; McGeer, Allison; Risch, Lorenz; Friedl, Andrée; Schlegel, Matthias; Schmid, Dagmar; Vernazza, Pietro; Kahlert, Christian R.; Köhler, Philipp

doi:10.1101/2021.10.19.21265187

Cited by 6 publications

(8 citation statements)

References 40 publications

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“…Sex hormone differences in immune response [24] and autoimmunity triggered by SARS-CoV-2 have been suggested to be involved in the disease pathogenesis of long COVID [23]. Other studies have found that individuals with more symptoms during the acute phase were at a higher risk for developing long COVID [9, 14]. There are conflicting results regarding age in the risk for developing long COVID.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, we observed that non-confirmed COVID-19 cases reported similar residual symptoms after acute illness, albeit at a much lower frequency. Few studies have included a control group composed of symptomatic patients that tested negative for SARS-CoV-2 [14,30]. In a cohort of healthcare workers, olfactory disorders and hair loss were related to long COVID while positive and negative cases both had similar frequencies of 12/26 exhaustion/burnout and fatigue [14].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and risk factors for long COVID after mild disease: a longitudinal study with a symptomatic control group

Cazé

Cerqueira‐Silva

Bomfim

et al. 2022

Preprint

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BackgroundThere is limited data on the prevalence and risk factors for long COVID, with a shortage of prospective studies with appropriate control groups and adequate sample size. We therefore performed a prospective study to determine the prevalence and risk factors for long COVID. MethodsWe recruited patients age ≥ 15 years who were clinically suspected of having acute SARS-CoV-2 infection from September 2020 to April 2021. Nasopharyngeal swabs were collected for RT-PCR 3-5 days post symptom onset. Clinical and sociodemographic characteristics were collected using structured questionnaires from persons positive and negative for SARS-COV-2. Follow-up was performed by telephone interview to assess early outcomes and persistent symptoms. For COVID-19 cases, 5D-3L EuroQol questionnaire was used to assess the impact of symptoms on quality of life.ResultsWe followed 814 participants (412 COVD-19 positive and 402 COVID-19 negative persons) of whom the majority (741 / 814) had mild symptoms. Both the COVID-19 positive and the COVID-19 negative groups had similar sociodemographic and clinical characteristics, except for the rate of hospitalization (15.8% vs 1.5%, respectively). One month after disease onset, 122 (29.6%) individuals reported residual symptoms in the COVID-19 positive group or the long COVID group versus 24 (6%) individuals in the COVID-19 negative group. In the long COVID group, fatigue, olfactory disorder, and myalgia were the most frequent symptoms which occurred in the acute phase. Compared to recovered patients, female sex, older age and having > 5 symptoms during the acute phase were risk factors for long COVID. Quality of life was evaluated in 102 out of 122 cases of long COVID with 57 (55.9%) reporting an impact in at least one dimension of the EuroQol 5D-3L questionnaire.ConclusionIn this prospective study consisting predominantly of patients with mild disease, the persistence of symptoms after acute disease was highly associated with long COVID-19 (29.6% vs 6% of COVID negative group). The risk factors for long COVID were older age, female sex, and polysymptomatic acute disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors for long COVID after mild disease: a longitudinal study with a symptomatic control group

Cazé

Cerqueira‐Silva

Bomfim

et al. 2022

Preprint

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“…It is assumed that only initially symptomatic patients are at risk of long COVID. 22 Full calculations are detailed in Appendix 2.…”

Section: ‫ݕݐܾ݅݀݅ݎܯ‬ ൌ ‫݈݁ܿ݊݁ܽݒ݁ݎܲ‬ ൈ ‫݊݅ݐܽݎݑܦ‬ ൈ ‫ݕݐ݅ݎ݁ݒ݁ܵ‬mentioning

confidence: 99%

“…1 െ ሺ1 െ ‫ܹܦ‬ ሻ ൈ ሺ1 െ ‫ܹܦ‬ ሻ It was assumed that only initially symptomatic patients are at risk of long COVID 17 , and that calculations including all three-way (or higher) combinations of symptoms would make negligible difference.…”

Section: Morbidity Calculationsmentioning

confidence: 99%

The health impact of long COVID during the 2021-2022 Omicron wave in Australia: a quantitative burden of disease study

Howe

Szanyi

Blakely

2022

Preprint

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Objectives To quantify the morbidity impact of long COVID in Australia during the 2021-2022 Omicron wave in comparison to acute COVID-19 morbidity and mortality, and to other causes of morbidity and mortality in Australia. Design Burden of disease study using inputs from previously published population-based case-control, cross-sectional, or cohort studies. Setting Australia Participants People with symptomatic COVID-19 infection from 10/12/21 to 09/04/22. Main outcomes measured Years lived with disability (YLDs) from acute COVID-19 and long COVID measured as the product of the prevalence, duration and severity of each long COVID symptom determined from existing literature, summed across all long COVID symptoms and applied to the population of COVID-19 surviving cases in Australia during the 2021-2022 Omicron wave. Additionally, acute COVID YLDs and years of life lost from COVID deaths were estimated to generate total COVID-19 disability-adjusted life years (DALYs). Results During the Omicron wave in Australia, 5,300 (95% uncertainty interval [UI] 2,200-8,400) YLDs were attributable to long COVID, accounting for 74% of the overall YLDs from COVID-19 infections in this period. The overall DALYs due to COVID-19 in this four-month period were 51,000 (95% UI 21,000-80,900), comprising 2.4% of total DALYs. This is comparable to the health loss caused by dementia and drug use disorders. Conclusion Long COVID requires consideration in pandemic policy planning given it is responsible for the majority of the total morbidity loss from COVID-19, even during an Omicron wave in a highly vaccinated population. Further research into the symptom profile and duration of long COVID following Omicron infection, and more robust severity measurement, will allow for more accurate estimation of long COVID morbidity.

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“…Therefore, it is important to understand if physical activity can play a protective role on the ANS after SARS-CoV-2 infection. Antagonic effects of BMI and physical activity were observed in the management of neurocognitive and fatigue symptoms, and in the incidence of post-acute sequelae SARS-CoV-2 infection (PASC) in healthcare workers [31].…”

Section: Introductionmentioning

confidence: 99%

Role of Body Mass and Physical Activity in Autonomic Function Modulation on Post-COVID-19 Condition: An Observational Subanalysis of Fit-COVID Study

Freire

Lira

Morano

et al. 2022

IJERPH

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The harmful effects of coronavirus disease 2019 (COVID-19) can reach the autonomic nervous system (ANS) and endothelial function. Therefore, the detrimental multiorgan effects of COVID-19 could be induced by deregulations in ANS that may persist after the acute SARS-CoV-2 infection. Additionally, investigating the differences in ANS response in overweight/obese, and physically inactive participants who had COVID-19 compared to those who did not have the disease is necessary. The aim of the study was to analyze the autonomic function of young adults after mild-to-moderate infection with SARS-CoV-2 and to assess whether body mass index (BMI) and levels of physical activity modulates autonomic function in participants with and without COVID-19. Patients previously infected with SARS-CoV-2 and healthy controls were recruited for this cross-sectional observational study. A general anamnesis was taken, and BMI and physical activity levels were assessed. The ANS was evaluated through heart rate variability. A total of 57 subjects were evaluated. Sympathetic nervous system activity in the post-COVID-19 group was increased (stress index; p = 0.0273). They also presented lower values of parasympathetic activity (p < 0.05). Overweight/obese subjects in the post-COVID-19 group presented significantly lower parasympathetic activity and reduced global variability compared to non-obese in control group (p < 0.05). Physically inactive subjects in the post-COVID-19 group presented significantly higher sympathetic activity than active subjects in the control group. Parasympathetic activity was significantly increased in physically active subjects in the control group compared to the physically inactive post-COVID-19 group (p < 0.05). COVID-19 promotes changes in the ANS of young adults, and these changes are modulated by overweight/obesity and physical activity levels.

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Symptoms compatible with long-COVID in healthcare workers with and without SARS-CoV-2 infection – results of a prospective multicenter cohort

Cited by 6 publications

References 40 publications

Prevalence and risk factors for long COVID after mild disease: a longitudinal study with a symptomatic control group

Prevalence and risk factors for long COVID after mild disease: a longitudinal study with a symptomatic control group

The health impact of long COVID during the 2021-2022 Omicron wave in Australia: a quantitative burden of disease study

Role of Body Mass and Physical Activity in Autonomic Function Modulation on Post-COVID-19 Condition: An Observational Subanalysis of Fit-COVID Study

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