Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection
BackgroundThe understanding of Post-acute sequelae of SARS-CoV-2 infection (PASC) can be improved by longitudinal assessment of symptoms encompassing the acute illness period. To gain insight into the various disease trajectories of PASC, we assessed symptom evolution and clinical factors associated...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1227883/full |
| _version_ | 1797659156099891200 |
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| author | Chen Chen Sairam Parthasarathy Jacqueline M. Leung Michelle J. Wu Katherine A. Drake Vanessa K. Ridaura Howard C. Zisser William A. Conrad Victor F. Tapson James N. Moy Christopher R. deFilippi Ivan O. Rosas Bellur S. Prabhakar Mujeeb Basit Mirella Salvatore Mirella Salvatore Jerry A. Krishnan Charles C. Kim |
| author_facet | Chen Chen Sairam Parthasarathy Jacqueline M. Leung Michelle J. Wu Katherine A. Drake Vanessa K. Ridaura Howard C. Zisser William A. Conrad Victor F. Tapson James N. Moy Christopher R. deFilippi Ivan O. Rosas Bellur S. Prabhakar Mujeeb Basit Mirella Salvatore Mirella Salvatore Jerry A. Krishnan Charles C. Kim |
| author_sort | Chen Chen |
| collection | DOAJ |
| description | BackgroundThe understanding of Post-acute sequelae of SARS-CoV-2 infection (PASC) can be improved by longitudinal assessment of symptoms encompassing the acute illness period. To gain insight into the various disease trajectories of PASC, we assessed symptom evolution and clinical factors associated with the development of PASC over 3 months, starting with the acute illness period.MethodsWe conducted a prospective cohort study to identify parameters associated with PASC. We performed cluster and case control analyses of clinical data, including symptomatology collected over 3 months following infection.ResultsWe identified three phenotypic clusters associated with PASC that could be characterized as remittent, persistent, or incident based on the 3-month change in symptom number compared to study entry: remittent (median; min, max: −4; −17, 3), persistent (−2; −14, 7), or incident (4.5; −5, 17) (p = 0.041 remittent vs. persistent, p < 0.001 remittent vs. incident, p < 0.001 persistent vs. incident). Despite younger age and lower hospitalization rates, the incident phenotype had a greater number of symptoms (15; 8, 24) and a higher proportion of participants with PASC (63.2%) than the persistent (6; 2, 9 and 52.2%) or remittent clusters (1; 0, 6 and 18.7%). Systemic corticosteroid administration during acute infection was also associated with PASC at 3 months [OR (95% CI): 2.23 (1.14, 4.36)].ConclusionAn incident disease phenotype characterized by symptoms that were absent during acute illness and the observed association with high dose steroids during acute illness have potential critical implications for preventing PASC. |
| first_indexed | 2024-03-11T18:09:47Z |
| format | Article |
| id | doaj.art-06e6ac9fbb394bddaa7c6e1b0be5a663 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-11T18:09:47Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-06e6ac9fbb394bddaa7c6e1b0be5a6632023-10-16T15:18:22ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-10-011010.3389/fmed.2023.12278831227883Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infectionChen Chen0Sairam Parthasarathy1Jacqueline M. Leung2Michelle J. Wu3Katherine A. Drake4Vanessa K. Ridaura5Howard C. Zisser6William A. Conrad7Victor F. Tapson8James N. Moy9Christopher R. deFilippi10Ivan O. Rosas11Bellur S. Prabhakar12Mujeeb Basit13Mirella Salvatore14Mirella Salvatore15Jerry A. Krishnan16Charles C. Kim17Verily Life Sciences, South San Francisco, CA, United StatesDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona, Tucson, AZ, United StatesVerily Life Sciences, South San Francisco, CA, United StatesVerily Life Sciences, South San Francisco, CA, United StatesVerily Life Sciences, South San Francisco, CA, United StatesVerily Life Sciences, South San Francisco, CA, United StatesVerily Life Sciences, South San Francisco, CA, United StatesProvidence Little Company of Mary Medical Center Torrance, Torrance, CA, United StatesDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United StatesDepartment of Internal Medicine, Rush University Medical Center, Chicago, IL, United StatesInova Heart and Vascular Institute, Falls Church, VA, United StatesDepartment of Medicine, Baylor College of Medicine, Houston, TX, United StatesDepartment of Microbiology and Immunology, University of Illinois–College of Medicine, Chicago, IL, United StatesDepartment of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States0Department of Medicine, Weill Cornell Medicine, New York, NY, United States1Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States2Breathe Chicago Center, University of Illinois Chicago, Chicago, IL, United StatesVerily Life Sciences, South San Francisco, CA, United StatesBackgroundThe understanding of Post-acute sequelae of SARS-CoV-2 infection (PASC) can be improved by longitudinal assessment of symptoms encompassing the acute illness period. To gain insight into the various disease trajectories of PASC, we assessed symptom evolution and clinical factors associated with the development of PASC over 3 months, starting with the acute illness period.MethodsWe conducted a prospective cohort study to identify parameters associated with PASC. We performed cluster and case control analyses of clinical data, including symptomatology collected over 3 months following infection.ResultsWe identified three phenotypic clusters associated with PASC that could be characterized as remittent, persistent, or incident based on the 3-month change in symptom number compared to study entry: remittent (median; min, max: −4; −17, 3), persistent (−2; −14, 7), or incident (4.5; −5, 17) (p = 0.041 remittent vs. persistent, p < 0.001 remittent vs. incident, p < 0.001 persistent vs. incident). Despite younger age and lower hospitalization rates, the incident phenotype had a greater number of symptoms (15; 8, 24) and a higher proportion of participants with PASC (63.2%) than the persistent (6; 2, 9 and 52.2%) or remittent clusters (1; 0, 6 and 18.7%). Systemic corticosteroid administration during acute infection was also associated with PASC at 3 months [OR (95% CI): 2.23 (1.14, 4.36)].ConclusionAn incident disease phenotype characterized by symptoms that were absent during acute illness and the observed association with high dose steroids during acute illness have potential critical implications for preventing PASC.https://www.frontiersin.org/articles/10.3389/fmed.2023.1227883/fullPASCsymptom clusterslong COVIDSARS-CoV-2COVID-19 |
| spellingShingle | Chen Chen Sairam Parthasarathy Jacqueline M. Leung Michelle J. Wu Katherine A. Drake Vanessa K. Ridaura Howard C. Zisser William A. Conrad Victor F. Tapson James N. Moy Christopher R. deFilippi Ivan O. Rosas Bellur S. Prabhakar Mujeeb Basit Mirella Salvatore Mirella Salvatore Jerry A. Krishnan Charles C. Kim Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection Frontiers in Medicine PASC symptom clusters long COVID SARS-CoV-2 COVID-19 |
| title | Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection |
| title_full | Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection |
| title_fullStr | Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection |
| title_full_unstemmed | Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection |
| title_short | Distinct temporal trajectories and risk factors for Post-acute sequelae of SARS-CoV-2 infection |
| title_sort | distinct temporal trajectories and risk factors for post acute sequelae of sars cov 2 infection |
| topic | PASC symptom clusters long COVID SARS-CoV-2 COVID-19 |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1227883/full |
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