Severe fatigue and persistent symptoms at three months following SARS-CoV-2 infections during the pre-delta, delta, and omicron time periods: a multicenter�…
Clinical infectious diseases: an official publication of the Infectious�…, 2023•europepmc.org
Background Most research on SARS-CoV-2 variants focuses on initial symptomatology with
limited data on longer-term sequelae. We sought to characterize the prevalence and
differences in prolonged symptoms at three months post SARS-CoV-2-infection across the
three major variant time-periods (pre-Delta, Delta, and Omicron). Methods This multicenter
prospective cohort study of adults with acute illness tested for SARS-CoV-2 compared
fatigue severity, fatigue symptoms, individual and organ system-based symptoms, and�…
limited data on longer-term sequelae. We sought to characterize the prevalence and
differences in prolonged symptoms at three months post SARS-CoV-2-infection across the
three major variant time-periods (pre-Delta, Delta, and Omicron). Methods This multicenter
prospective cohort study of adults with acute illness tested for SARS-CoV-2 compared
fatigue severity, fatigue symptoms, individual and organ system-based symptoms, and�…
Background
Most research on SARS-CoV-2 variants focuses on initial symptomatology with limited data on longer-term sequelae. We sought to characterize the prevalence and differences in prolonged symptoms at three months post SARS-CoV-2-infection across the three major variant time-periods (pre-Delta, Delta, and Omicron).
Methods
This multicenter prospective cohort study of adults with acute illness tested for SARS-CoV-2 compared fatigue severity, fatigue symptoms, individual and organ system-based symptoms, and presence of≥ 3 total symptoms across variants among COVID-positive and COVID-negative participants 3 months after their initial SARS-CoV-2 diagnosis. Variant periods were defined by dates with≥ 50% dominant strain. We performed a sensitivity analysis using≥ 90% dominance threshold and multivariable logistic regression modeling to estimate the independent effects of each variant adjusting for socio-demographic characteristics, baseline health, and vaccine status.
Results
The study included 3,223 participants (2,402 COVID-positive and 821 COVID-negative). Among the COVID-positive cohort, 463 (19.3%) were pre-Delta, 1,198 (49.9%) during Delta, and 741 (30.8%) during Omicron. Prolonged severe fatigue was highest in the pre-Delta COVID-positive cohort compared with Delta and Omicron cohorts (16.7% vs 11.5% vs 12.3%, respectively; p= 0.017), as was presence of≥ 3 prolonged symptoms (28.4% vs 21.7% vs 16.0%; p< 0.001). No difference was seen in the COVID-negative cohort between variant time-periods. In multivariable models, there was no difference in severe fatigue between variants. There was decreased odds of having≥ 3 symptoms in Omicron compared with other variants; this was not significant after adjusting for vaccination status.
Conclusions
Prolonged symptoms following SARS-CoV-2 infection were more common among participants infected during the pre-Delta period compared with Delta and Omicron periods; however, these differences were no longer significant after adjusting for vaccination status. This suggests a potential beneficial effect of vaccination on the risk of developing long-term symptoms.
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