Sex, vaccination status, and comorbidities influence long COVID persistence

• Main Authors: Trevon Fuller (Author), Roxana Flores Mamani (Author), Heloísa Ferreira Pinto Santos (Author), Otávio Melo Espíndola (Author), Lusiele Guaraldo (Author), Carolina Lopes Melo (Author), Michele Fernanda Borges Da Silva (Author), Guilherme Amaral Calvet (Author), Leonardo Soares Bastos (Author), Marília Sá Carvalho (Author), Patrícia Brasil (Author)
• Format: Book
• Published: Elsevier, 2024-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Background: There is interest in the public health impact of Long COVID, defined as symptoms that persist or begin after SARS-CoV-2 infection. We aimed to identify demographic and clinical risk factors associated with Long COVID over time in an Upper Middle-Income Country (UMIC) and potential biomarkers predictive of symptom trajectory. Methods: Prospective cohort study of adults with mild SARS-COV-2 during the Omicron period. We tracked symptom persistence and IgG antibody titers against the spike S1 subunit. Results: Of 383 participants, 276 had confirmed SARS-CoV-2 infection. Long COVID persisted for ≥ two months in 21 % and ≥ 12 months in 5 %. The most common symptoms were fatigue, upper respiratory symptoms, and myalgia/arthralgia: 15 % had fatigue for ≥ one month, 10 % for ≥ two months, and 5 % ≥ three months. Upper respiratory symptoms lasted ≥ one month in 17 %, ≥ two months in 7 %, and ≥ three months in 3 %. Fully 9 % reported myalgia/arthralgia lasting ≥ one month, 6 % ≥ two months, and 4 % ≥ three months. Risk factors for symptom persistence included female sex, not being fully vaccinated, and comorbidities. Participants experiencing persistent fatigue had lower anti-S1 IgG titers. Conclusions: In this population, symptom persistence declined after the acute phase, but 5 % of participants did not fully recover. Even in a population that was almost fully vaccinated, women, individuals with comorbidities, and the few remaining people who were unvaccinated were at greater risk for Long COVID. Immunoglobulins may have utility as a biomarker of Long COVID fatigue in this population.

Item Description

1876-0341
10.1016/j.jiph.2024.102562