Impact of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination and Booster on Coronavirus Disease 2019 (COVID-19) Symptom Severity Over Time in the COVID-OUT Trial.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
08 02 2023
Historique:
received: 03 07 2022
pubmed: 21 9 2022
medline: 11 2 2023
entrez: 20 9 2022
Statut: ppublish

Résumé

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has decreasing protection from acquiring any infection with emergence of new variants; however, vaccination continues to protect against progression to severe coronavirus disease 2019 (COVID-19). The impact of vaccination status on symptoms over time is less clear. Within a randomized trial on early outpatient COVID-19 therapy testing metformin, ivermectin, and/or fluvoxamine, participants recorded symptoms daily for 14 days. Participants were given a paper symptom diary allowing them to circle the severity of 14 symptoms as none (0), mild (1), moderate (2), or severe (3). This is a secondary analysis of clinical trial data on symptom severity over time using generalized estimating equations comparing those unvaccinated, SARS-CoV-2 vaccinated with primary vaccine series only, or vaccine-boosted. The parent clinical trial prospectively enrolled 1323 participants, of whom 1062 (80%) prospectively recorded some daily symptom data. Of these, 480 (45%) were unvaccinated, 530 (50%) were vaccinated with primary series only, and 52 (5%) vaccine-boosted. Overall symptom severity was least for the vaccine-boosted group and most severe for unvaccinated at baseline and over the 14 days (P < .001). Individual symptoms were least severe in the vaccine-boosted group including cough, chills, fever, nausea, fatigue, myalgia, headache, and diarrhea, as well as smell and taste abnormalities. Results were consistent over Delta and Omicron variant time periods. SARS-CoV-2 vaccine-boosted participants had the least severe symptoms during COVID-19, which abated the quickest over time. Clinical Trial Registration. NCT04510194.

Sections du résumé

BACKGROUND
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has decreasing protection from acquiring any infection with emergence of new variants; however, vaccination continues to protect against progression to severe coronavirus disease 2019 (COVID-19). The impact of vaccination status on symptoms over time is less clear.
METHODS
Within a randomized trial on early outpatient COVID-19 therapy testing metformin, ivermectin, and/or fluvoxamine, participants recorded symptoms daily for 14 days. Participants were given a paper symptom diary allowing them to circle the severity of 14 symptoms as none (0), mild (1), moderate (2), or severe (3). This is a secondary analysis of clinical trial data on symptom severity over time using generalized estimating equations comparing those unvaccinated, SARS-CoV-2 vaccinated with primary vaccine series only, or vaccine-boosted.
RESULTS
The parent clinical trial prospectively enrolled 1323 participants, of whom 1062 (80%) prospectively recorded some daily symptom data. Of these, 480 (45%) were unvaccinated, 530 (50%) were vaccinated with primary series only, and 52 (5%) vaccine-boosted. Overall symptom severity was least for the vaccine-boosted group and most severe for unvaccinated at baseline and over the 14 days (P < .001). Individual symptoms were least severe in the vaccine-boosted group including cough, chills, fever, nausea, fatigue, myalgia, headache, and diarrhea, as well as smell and taste abnormalities. Results were consistent over Delta and Omicron variant time periods.
CONCLUSIONS
SARS-CoV-2 vaccine-boosted participants had the least severe symptoms during COVID-19, which abated the quickest over time. Clinical Trial Registration. NCT04510194.

Identifiants

pubmed: 36124697
pii: 6702474
doi: 10.1093/cid/ciac772
pmc: PMC9494422
doi:

Substances chimiques

COVID-19 Vaccines 0

Banques de données

ClinicalTrials.gov
['NCT04510194']

Types de publication

Clinical Trial Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1-e9

Subventions

Organisme : NIDDK NIH HHS
ID : K23 DK124654
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK048520
Pays : United States

Informations de copyright

© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Déclaration de conflit d'intérêts

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Auteurs

David R Boulware (DR)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Thomas A Murray (TA)

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Jennifer L Proper (JL)

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Christopher J Tignanelli (CJ)

Department of Surgery, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

John B Buse (JB)

Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.

David M Liebovitz (DM)

Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Jacinda M Nicklas (JM)

Department of Medicine, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA.

Kenneth Cohen (K)

UnitedHealth Group, Optum Labs, Minnetonka, Minnesota, USA.

Michael A Puskarich (MA)

Department of Emergency Medicine, School of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA.

Hrishikesh K Belani (HK)

Department of Medicine, Olive View - University of California, Los Angeles, California, USA.

Lianne K Siegel (LK)

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Nichole R Klatt (NR)

Department of Surgery, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

David J Odde (DJ)

Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA.

Amy B Karger (AB)

Department of Laboratory Medicine and Pathology, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Nicholas E Ingraham (NE)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Katrina M Hartman (KM)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Via Rao (V)

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Aubrey A Hagen (AA)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Barkha Patel (B)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Sarah L Fenno (SL)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Nandini Avula (N)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Neha V Reddy (NV)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Spencer M Erickson (SM)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Sarah Lindberg (S)

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Regina Fricton (R)

Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Samuel Lee (S)

Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Adnin Zaman (A)

Department of Medicine, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA.

Hanna G Saveraid (HG)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Walker J Tordsen (WJ)

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA.

Matthew F Pullen (MF)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

Nancy E Sherwood (NE)

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Jared D Huling (JD)

Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.

Carolyn T Bramante (CT)

Department of Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.

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