Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection.

Autor:	Thaweethai T; Massachusetts General Hospital, Boston.; Harvard Medical School, Boston, Massachusetts., Jolley SE; University of Colorado Anschutz Medical Campus, Aurora., Karlson EW; Brigham and Women's Hospital, Boston, Massachusetts., Levitan EB; University of Alabama at Birmingham., Levy B; Harvard Medical School, Boston, Massachusetts.; Brigham and Women's Hospital, Boston, Massachusetts., McComsey GA; Case Western Reserve University, Cleveland, Ohio., McCorkell L; Patient-Led Research Collaborative, Calabasas, California., Nadkarni GN; Icahn School of Medicine at Mount Sinai, New York, New York., Parthasarathy S; The University of Arizona College of Medicine, Tucson., Singh U; Stanford University School of Medicine, Stanford, California., Walker TA; Emory University School of Medicine, Atlanta, Georgia., Selvaggi CA; Massachusetts General Hospital, Boston., Shinnick DJ; Massachusetts General Hospital, Boston., Schulte CCM; Massachusetts General Hospital, Boston., Atchley-Challenner R; Mass General Brigham, Boston, Massachusetts., Alba GA; Massachusetts General Hospital, Boston., Alicic R; University of Washington, Seattle., Altman N; University of Colorado Anschutz Medical Campus, Aurora., Anglin K; University of California, San Francisco., Argueta U; University of California, San Francisco., Ashktorab H; Howard University, Washington, DC., Baslet G; Brigham and Women's Hospital, Boston, Massachusetts., Bassett IV; Massachusetts General Hospital, Boston., Bateman L; Bateman Horne Center, Salt Lake City, Utah., Bedi B; Emory University School of Medicine, Atlanta, Georgia., Bhattacharyya S; Brigham and Women's Hospital, Boston, Massachusetts., Bind MA; Massachusetts General Hospital, Boston., Blomkalns AL; Stanford University, Stanford, California., Bonilla H; Stanford University, Stanford, California., Brim H; Pathology Department, Howard University, Washington, DC., Bush PA; Kaiser Foundation Health Plan of Georgia Inc, Atlanta., Castro M; University of Kansas Medical Center, Kansas City., Chan J; Massachusetts General Hospital, Boston., Charney AW; Icahn School of Medicine at Mount Sinai, New York, New York., Chen P; Cedars-Sinai Medical Center, Los Angeles, California., Chibnik LB; Massachusetts General Hospital, Boston., Chu HY; University of Washington School of Medicine, Seattle., Clifton RG; George Washington University, Washington, DC., Costantine MM; The Ohio State University, Columbus., Cribbs SK; Emory University School of Medicine, Atlanta, Georgia., Davila Nieves SI; Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico., Deeks SG; University of California, San Francisco., Duven A; Swedish Medical Center, Seattle, Washington., Emery IF; MaineHealth, Portland., Erdmann N; University of Alabama at Birmingham., Erlandson KM; University of Colorado Anschutz Medical Campus, Aurora., Ernst KC; The University of Arizona, Tucson., Farah-Abraham R; Emory University, Atlanta, Georgia., Farner CE; The University of Texas Health Science Center at San Antonio., Feuerriegel EM; University of Colorado Anschutz Medical Campus, Aurora., Fleurimont J; University of Illinois Chicago., Fonseca V; Tulane University Health Sciences Center, New Orleans, Louisiana., Franko N; University of Washington, Seattle., Gainer V; Partners HealthCare Systems, Boston, Massachusetts., Gander JC; Kaiser Permanente Georgia, Atlanta., Gardner EM; Denver Health, Denver, Colorado., Geng LN; Stanford University, Stanford, California., Gibson KS; MetroHealth Medical Center, Cleveland, Ohio., Go M; Stanford University School of Medicine, Stanford, California., Goldman JD; Swedish Medical Center, Seattle, Washington., Grebe H; University of California, San Francisco., Greenway FL; Pennington Biomedical Research Center, Baton Rouge, Louisiana., Habli M; TriHealth, Cincinnati, Ohio., Hafner J; University of Illinois Chicago College of Medicine., Han JE; Emory University School of Medicine, Atlanta, Georgia., Hanson KA; University of Illinois College of Medicine at Peoria., Heath J; Institute for Systems Biology, Seattle, Washington., Hernandez C; UH Cleveland Medical Center, Cleveland, Ohio., Hess R; University of Utah Schools of the Health Sciences, Salt Lake City., Hodder SL; West Virginia Clinical and Translational Science Institute, Morgantown., Hoffman MK; Christiana Care Health Services Inc, Newark, Delaware., Hoover SE; Sanford Health, Sioux Falls, South Dakota., Huang B; University of California, San Francisco., Hughes BL; Duke University, Durham, North Carolina., Jagannathan P; Stanford University, Stanford, California., John J; Cambridge Health Alliance, Cambridge, Massachusetts., Jordan MR; Tufts Medical Center, Boston, Massachusetts., Katz SD; New York University Grossman School of Medicine, New York., Kaufman ES; MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio., Kelly JD; University of California, San Francisco., Kelly SW; University of Illinois College of Medicine at Peoria., Kemp MM; University of Washington, Seattle., Kirwan JP; Pennington Biomedical Research Center, Baton Rouge, Louisiana., Klein JD; University of Illinois Chicago., Knox KS; The University of Arizona College of Medicine, Phoenix., Krishnan JA; University of Illinois Hospital and Health Sciences System, Chicago., Kumar A; Stanford University School of Medicine, Stanford, California., Laiyemo AO; Howard University College of Medicine, Washington, DC., Lambert AA; University of Washington, Seattle., Lanca M; Harvard Medical School, Boston, Massachusetts., Lee-Iannotti JK; The University of Arizona College of Medicine, Phoenix., Logarbo BP; Tulane University, New Orleans, Louisiana., Longo MT; Tulane School of Medicine, New Orleans, Louisiana., Luciano CA; Universidad de Puerto Rico, San Juan, Puerto Rico., Lutrick K; The University of Arizona, Tucson., Maley JH; Beth Israel Deaconess Medical Center, Boston, Massachusetts., Mallett G; Department of ObGyn/Maternal Fetal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois., Marathe JG; Boston University, Boston, Massachusetts., Marconi V; Emory University, Atlanta, Georgia., Marshall GD; University of Mississippi, Oxford., Martin CF; Emory University, Atlanta, Georgia., Matusov Y; Cedars-Sinai Medical Center, Los Angeles, California., Mehari A; Howard University College of Medicine, Washington, DC., Mendez-Figueroa H; McGovern Medical School at The University of Texas Health Science Center at Houston., Mermelstein R; University of Illinois Chicago., Metz TD; University of Utah Health, Salt Lake City., Morse R; Massachusetts General Hospital, Boston., Mosier J; University of Arizona, Tucson., Mouchati C; Case Western Reserve University School of Medicine, Cleveland, Ohio., Mullington J; Harvard Medical School, Boston, Massachusetts., Murphy SN; Massachusetts General Hospital, Boston., Neuman RB; Kaiser Foundation Health Plan of Georgia Inc, Atlanta., Nikolich JZ; The University of Arizona, Tucson., Ofotokun I; Emory University School of Medicine, Atlanta, Georgia., Ojemakinde E; Morehouse School of Medicine, Atlanta, Georgia., Palatnik A; Medical College of Wisconsin, Milwaukee., Palomares K; Saint Peter's University Hospital, Brunswick, New Jersey., Parimon T; Cedars-Sinai Health System, Los Angeles, California., Parry S; University of Pennsylvania, Philadelphia., Patterson JE; The University of Texas Health Science Center at San Antonio., Patterson TF; The University of Texas Health Science Center at San Antonio., Patzer RE; Emory University, Atlanta, Georgia., Peluso MJ; University of California, San Francisco., Pemu P; Morehouse School of Medicine, Atlanta, Georgia., Pettker CM; Yale School of Medicine, New Haven, Connecticut., Plunkett BA; Harvard Medical School, Boston, Massachusetts.; NorthShore University HealthSystem, Evanston, Illinois., Pogreba-Brown K; The University of Arizona, Tucson., Poppas A; Warren Alpert Medical School, Brown University, Providence, Rhode Island., Quigley JG; University of Illinois Chicago., Reddy U; Columbia University Irving Medical Center, New York, New York., Reece R; West Virginia University School of Medicine, Morgantown., Reeder H; Massachusetts General Hospital, Boston., Reeves WB; Department of Medicine, The University of Texas Health Science Center at San Antonio., Reiman EM; Banner Alzheimer's Institute, Phoenix, Arizona., Rischard F; Banner University Medical Center Tucson, Arizona., Rosand J; Massachusetts General Hospital, Boston., Rouse DJ; Brown University, Providence, Rhode Island., Ruff A; The University of Kansas Medical Center, Kansas City., Saade G; Eastern Virginia Medical School, Norfolk., Sandoval GJ; Milken Institute of Public Health, The George Washington University, Washington, DC., Santana JL; School of Medicine, University of Puerto Rico, San Juan, Puerto Rico., Schlater SM; University of Utah Health, Salt Lake City., Sciurba FC; Division of Pulmonary and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania., Shepherd F; Boston University School of Medicine, Boston, Massachusetts., Sherif ZA; Howard University College of Medicine, Washington, DC., Simhan H; University of Pittsburgh, Pittsburgh, Pennsylvania., Singer NG; MetroHealth Medical Center, Cleveland, Ohio., Skupski DW; Weill Cornell Medicine, New York, New York., Sowles A; University of Utah Health, Salt Lake City., Sparks JA; Brigham and Women's Hospital, Boston, Massachusetts., Sukhera FI; The University of Oklahoma, Norman., Taylor BS; The University of Texas Health Science Center at San Antonio., Teunis L; Emory University, Atlanta, Georgia., Thomas RJ; Beth Israel Deaconess Medical Center, Boston, Massachusetts., Thorp JM; The University of North Carolina at Chapel Hill., Thuluvath P; Mercy Medical Center, Baltimore, Maryland., Ticotsky A; Cambridge Health Alliance, Cambridge, Massachusetts., Tita AT; University of Alabama, Birmingham., Tuttle KR; University of Washington, Seattle., Urdaneta AE; Stanford University School of Medicine, Stanford, California., Valdivieso D; University of California, San Francisco., VanWagoner TM; University of Oklahoma Health Sciences Center, Oklahoma City., Vasey A; University of Nebraska Medical Center, Omaha., Verduzco-Gutierrez M; The University of Texas Health Science Center at San Antonio., Wallace ZS; Massachusetts General Hospital, Boston., Ward HD; Tufts Medical Center, Boston, Massachusetts., Warren DE; University of Nebraska Medical Center, Omaha., Weiner SJ; The George Washington University Biostatistics Center, Rockville, Maryland., Welch S; West Virginia University, Morgantown., Whiteheart SW; University of Kentucky, Lexington., Wiley Z; Emory University, Atlanta, Georgia., Wisnivesky JP; Icahn School of Medicine at Mount Sinai, New York, New York., Yee LM; Feinberg School of Medicine, Northwestern University, Chicago, Illinois., Zisis S; Case Western Reserve University, Cleveland, Ohio., Horwitz LI; New York University Grossman School of Medicine, New York., Foulkes AS; Massachusetts General Hospital, Boston.; Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	JAMA [JAMA] 2023 Jun 13; Vol. 329 (22), pp. 1934-1946.
DOI:	10.1001/jama.2023.8823
Abstrakt:	Importance: SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals. Objective: To develop a definition of PASC using self-reported symptoms and describe PASC frequencies across cohorts, vaccination status, and number of infections. Design, Setting, and Participants: Prospective observational cohort study of adults with and without SARS-CoV-2 infection at 85 enrolling sites (hospitals, health centers, community organizations) located in 33 states plus Washington, DC, and Puerto Rico. Participants who were enrolled in the RECOVER adult cohort before April 10, 2023, completed a symptom survey 6 months or more after acute symptom onset or test date. Selection included population-based, volunteer, and convenience sampling. Exposure: SARS-CoV-2 infection. Main Outcomes and Measures: PASC and 44 participant-reported symptoms (with severity thresholds). Results: A total of 9764 participants (89% SARS-CoV-2 infected; 71% female; 16% Hispanic/Latino; 15% non-Hispanic Black; median age, 47 years [IQR, 35-60]) met selection criteria. Adjusted odds ratios were 1.5 or greater (infected vs uninfected participants) for 37 symptoms. Symptoms contributing to PASC score included postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements. Among 2231 participants first infected on or after December 1, 2021, and enrolled within 30 days of infection, 224 (10% [95% CI, 8.8%-11%]) were PASC positive at 6 months. Conclusions and Relevance: A definition of PASC was developed based on symptoms in a prospective cohort study. As a first step to providing a framework for other investigations, iterative refinement that further incorporates other clinical features is needed to support actionable definitions of PASC.
Databáze:	MEDLINE
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