Long-term symptoms after SARS-CoV-2 infection in a cohort of hospital employees: duration and predictive factors.
COVID-19
Healthcare worker
Long COVID
Post COVID syndrome
SARS-CoV-2
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
23 Jan 2024
23 Jan 2024
Historique:
received:
13
04
2023
accepted:
13
10
2023
medline:
24
1
2024
pubmed:
24
1
2024
entrez:
23
1
2024
Statut:
epublish
Résumé
To evaluate the frequency, duration and patterns of long-term coronavirus disease 2019 (COVID-19) symptoms and to analyse risk factors for long-lasting COVID-19 sequelae among a cohort of hospital employees (HEs). We conducted a survey regarding persistent COVID-19 related symptoms with all HEs from three medical centres in Cologne, Germany, who were tested SARS-CoV-2 PCR positive from March 2020 until May 2021. Duration of symptoms and possible risk factors for protracted COVID-19 course were analysed. Of 221 included HEs, a number of 104 HEs (47.1%) reported at least one persisting symptom for more than 90 days after initial SARS-CoV-2 detection. Each one cycle higher initial Ct value significantly increased the chances of overcoming symptoms (odds ratio [OR] 1.05; 95% confidence interval (95%CI) 1.01-1.09; p = 0.019). The occurrence of breathlessness within the first ten days (OR 7.89; 95%CI 1.87-41.43; p = 0.008), an initial Ct value under 30 (OR 3.36; 95%CI 1.22-9.94; p = 0.022) as well as the occurrence of anosmia or ageusia within the first ten days (OR 3.01; 95%CI 1.10-8.84; p = 0.037) showed a statistically significant association with increased odds of illness duration over 90 days. About half of the HEs suffered from long lasting symptoms over 90 days after almost entirely mild acute COVID-19. Predictive factors could possibly be used for early treatment to prevent development of long-term symptoms after COVID-19 in future.
Identifiants
pubmed: 38262969
doi: 10.1186/s12879-023-08710-1
pii: 10.1186/s12879-023-08710-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
119Informations de copyright
© 2024. The Author(s).
Références
Lai CC, Shih TP, Ko WC, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924. https://doi.org/10.1016/j.ijantimicag.2020.105924 . Epub 2020 Feb 17. PMID: 32081636; PMCID: PMC7127800.
doi: 10.1016/j.ijantimicag.2020.105924
pubmed: 32081636
pmcid: 7127800
Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199–207. https://doi.org/10.1056/NEJMoa2001316 . Epub 2020 Jan 29. PMID: 31995857; PMCID: PMC7121484.
doi: 10.1056/NEJMoa2001316
pubmed: 31995857
pmcid: 7121484
Gandjour A, Long COVID. Costs for the German economy and health care and pension system. BMC Health Serv Res. 2023;23(1):641. https://doi.org/10.1186/s12913-023-09601-6 . PMID: 37316880; PMCID: PMC10266873.
doi: 10.1186/s12913-023-09601-6
pubmed: 37316880
pmcid: 10266873
Robert Koch-Institut RKI. COVID-19 Dashboard. 2021. https://experience.arcgis.com/experience/478220a4c454480e823b17327b2bf1d4 (accessed 17.02.2022).
WHO Working Group on the Clinical Characterisation and Management of COVID-19 infection. A minimal common outcome measure set for COVID-19 clinical research. Lancet Infect Dis. 2020;20(8):e192–e7.
doi: 10.1016/S1473-3099(20)30483-7
Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220–32.
doi: 10.1016/S0140-6736(20)32656-8
pubmed: 33428867
pmcid: 7833295
Nasserie T, Hittle M, Goodman SN. Assessment of the frequency and Variety of persistent symptoms among patients with COVID-19: a systematic review. JAMA Netw open. 2021;4(5):e2111417.
doi: 10.1001/jamanetworkopen.2021.11417
pubmed: 34037731
pmcid: 8155823
Groff D, Sun A, Ssentongo AE, et al. Short-term and long-term rates of Postacute Sequelae of SARS-CoV-2 Infection: a systematic review. JAMA Netw open. 2021;4(10):e2128568.
doi: 10.1001/jamanetworkopen.2021.28568
pubmed: 34643720
pmcid: 8515212
Vedel Sørensen AI, Spiliopoulos L, Bager P, et al. Post-acute symptoms, new onset diagnoses and health problems 6 to 12 months after SARS-CoV-2 Infection: a nationwide questionnaire study in the adult Danish population. medRxiv. 2022. 2022.02.27.22271328.
Augustin M, Schommers P, Stecher M, et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Europe. 2021;6:100122.
doi: 10.1016/j.lanepe.2021.100122
pubmed: 34027514
National Institute for Health and Care Excellence (NICE)., Scottish Intercollegiate Guidelines Network (SIGN) and Royal College of General Practitioners (RCGP) (2022), COVID-19 rapid guideline: managing the longterm effects of COVID-19. Version 1.14 published on 01.03.2022 (accessed 10.08.2023).
World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus. 2021. https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 .
Wanney J, Lüsebrink J, Spölgen G, et al. Direct comparison of Altona-SARS-CoV-2 dual target RT-qPCR assay with commercial LAMP assay using throat washes in health care staff testing. J Clin Virol Plus. 2022;2(3):100088. https://doi.org/10.1016/j.jcvp.2022.100088 . Epub 2022 Jun 2. PMID: 35669098; PMCID: PMC9159961.
doi: 10.1016/j.jcvp.2022.100088
pubmed: 35669098
pmcid: 9159961
Malecki M, Luesebrink J, Wendel AF, et al. Analysis of external quality assessment samples revealed crucial performance differences between commercial RT-PCR assays for SARS-CoV-2 detection when taking extraction methods and real-time-PCR instruments into account. J Virol Methods. 2021;295:114202. https://doi.org/10.1016/j.jviromet.2021.114202 . Epub 2021 Jun 2. PMID: 34087340; PMCID: PMC8169234.
doi: 10.1016/j.jviromet.2021.114202
pubmed: 34087340
pmcid: 8169234
Jones R, Davis A, Stanley B, et al. Risk predictors and Symptom features of Long COVID within a Broad Primary Care Patient Population including both tested and untested patients. Pragmatic and Observational Research. 2021;12:93–104.
doi: 10.2147/POR.S316186
pubmed: 34408531
pmcid: 8366779
Westerlind E, Palstam A, Sunnerhagen KS, Persson HC. Patterns and predictors of sick leave after Covid-19 and long Covid in a national Swedish cohort. BMC Public Health. 2021;21(1):1023.
doi: 10.1186/s12889-021-11013-2
pubmed: 34059034
pmcid: 8164957
R Core Team. R: A Language and Environment for Statistical Computing. 2021. https://www.R-project.org/ .
Epskamp S, Cramer AOJ, Waldorp LJ, Schmittmann VD, Borsboom D. Qgraph: network visualizations of relationships in Psychometric Data. J Stat Soft. 2012;4:1–18.
Therneau TM. A Package for Survival Analysis in R. 2021. https://CRAN.R-project.org/package=survival .
Cox DR. Regression models and life tables. J R Stat Soc. 1972;34:187–202.
Agresti A. Categorical Data Analysis. 2nd ed. New York: John Wiley & Sons; 2002.
doi: 10.1002/0471249688
Robert Koch-Institut. COVID-19: Entlassungskriterien aus der Isolierung. 2023. https://edoc.rki.de/bitstream/handle/176904/6867/20_0316_Entlasskriterien_A3_V11.pdf?sequence=1&isAllowed=y : (accessed 10.08.2023).
Robert Koch-Institut. Hinweise zur Testung von Patientinnen und Patienten auf SARS-CoV-2. 2023. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Vorl_Testung_nCoV.html (accessed 10.08.2023).
Carvalho-Schneider C, Laurent E, Lemaignen A, et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infection: Official Publication Eur Soc Clin Microbiol Infect Dis. 2020;27(2):258–63.
doi: 10.1016/j.cmi.2020.09.052
Roessler M, Tesch F, Batram M et al. Post COVID-19 in children, adolescents, and adults: results of a matched cohort study including more than 150,000 individuals with COVID-19. medRxiv 2021: 2021.10.21.21265133.
Mehandru S, Merad M. Pathological sequelae of long-haul COVID. Nat Immunol. 2022;23(2):194–202.
doi: 10.1038/s41590-021-01104-y
pubmed: 35105985
pmcid: 9127978
Zazhytska M, Kodra A, Hoagland DA et al. Non-cell-autonomous disruption of nuclear architecture as a potential cause of COVID-19-induced anosmia. Cell 2022.
Etter MM, Martins A, Kulsvehagen T. L, Severe Neuro-COVID is associated with peripheral immune signatures, autoimmunity and signs of neurodegeneration: a prospective cross-sectional study. medRxiv 2022: 2022.02.18.22271039.
Raveendran AV, Jayadevan R, Sashidharan S, Long COVID. An overview. Diabetes & Metabolic Syndrome. 2021;15(3):869–75.
doi: 10.1016/j.dsx.2021.04.007
Yong SJ. Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infect Dis. 2021;53(10):737–54.
doi: 10.1080/23744235.2021.1924397
Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med 2022.
Karimzadeh S, Bhopal R, Nguyen Tien H. Review of infective dose, routes of transmission and outcome of COVID-19 caused by the SARS-COV-2: comparison with other respiratory viruses. Epidemiol Infect. 2021;149:e96. doi: 10.1017/S0950268821000790. Erratum in: Epidemiol Infect. 2021;149:e116. PMID: 33849679; PMCID: PMC8082124.
Van Damme W, Dahake R, van de Pas R et al. COVID-19: does the infectious inoculum dose-response relationship contribute to understanding heterogeneity in Disease severity and transmission dynamics? Medical hypotheses, Volume 146, 2021,110431.
Cohen K, Ren S, Heath K, et al. Risk of persistent and new clinical sequelae among adults aged 65 years and older during the post-acute phase of SARS-CoV-2 Infection: retrospective cohort study. BMJ. 2022;376:e068414.
doi: 10.1136/bmj-2021-068414
pubmed: 35140117
Subramanian A, Nirantharakumar K, Hughes S, et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med. 2022;28(8):1706–14.
doi: 10.1038/s41591-022-01909-w
pubmed: 35879616
pmcid: 9388369
Xie Y, Choi T, Al-Aly Z. Association of Treatment with Nirmatrelvir and the risk of Post-COVID-19 Condition. JAMA Intern Med. 2023;183(6):554–64.
doi: 10.1001/jamainternmed.2023.0743
pubmed: 36951829
pmcid: 10037200
Kuodi P, Gorelik Y, Zayyad H et al. Association between vaccination status and reported incidence of post-acute COVID-19 symptoms in Israel: a cross-sectional study of patients tested between March 2020 and November 2021. medRxiv 2022: 2022.01.05.22268800.