Impact of vaccination and variants of concern on long COVID clinical phenotypes.

Autor: Kenny G; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland. grace.kenny1@ucd.ie.; St Vincent's University Hospital, Dublin, Ireland. grace.kenny1@ucd.ie., McCann K; St Vincent's University Hospital, Dublin, Ireland., O'Brien C; School of Medicine, University College Dublin, Dublin, Ireland., O'Broin C; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland.; St Vincent's University Hospital, Dublin, Ireland., Tinago W; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland., Yousif O; Wexford General Hospital, Wexford, Ireland., O'Gorman T; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland.; Mater Misericordiae University Hospital, Dublin, Ireland., Cotter AG; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland.; School of Medicine, University College Dublin, Dublin, Ireland.; Mater Misericordiae University Hospital, Dublin, Ireland., Lambert JS; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland.; School of Medicine, University College Dublin, Dublin, Ireland.; Mater Misericordiae University Hospital, Dublin, Ireland., Feeney ER; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland.; St Vincent's University Hospital, Dublin, Ireland., de Barra E; Beaumont Hospital, Beaumont, Dublin 9, Ireland.; Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland., Sadlier C; Department of Infectious Diseases, Cork University Hospital, Wilton, Cork, Ireland., Landay A; Department of Internal Medicine, Rush University, Chicago, IL, USA., Doran P; Clinical Trials Institute, University of Galway, Galway, Ireland., Savinelli S; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland.; St Vincent's University Hospital, Dublin, Ireland., Mallon PWG; Centre for Experimental Pathogen Host Research, University College Dublin, Belfield Dublin 4, Ireland.; St Vincent's University Hospital, Dublin, Ireland.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2023 Nov 16; Vol. 23 (1), pp. 804. Date of Electronic Publication: 2023 Nov 16.
DOI: 10.1186/s12879-023-08783-y
Abstrakt: Background: Defining patterns of symptoms in long COVID is necessary to advance therapies for this heterogeneous condition. Here we aimed to describe clusters of symptoms in individuals with long COVID and explore the impact of the emergence of variants of concern (VOCs) and vaccination on these clusters.
Methods: In a prospective, multi centre cohort study, individuals with symptoms persisting > 4 weeks from acute COVID-19 were divided into two groups based on timing of acute infection; pre-Alpha VOC, denoted wild type (WT) group and post-Alpha VOC (incorporating alpha and delta dominant periods) denoted VOC group. We used multiple correspondence analysis (MCA) and hierarchical clustering in the WT and VOC groups to identify symptom clusters. We then used logistic regression to explore factors associated with individual symptoms.
Results: A total of 417 individuals were included in the analysis, 268 in WT and 149 in VOC groups respectively. In both groups MCA identified three similar clusters; a musculoskeletal (MSK) cluster characterised by joint pain and myalgia, a cardiorespiratory cluster and a less symptomatic cluster. Differences in characteristic symptoms were only seen in the cardiorespiratory cluster where a decrease in the frequency of palpitations (10% vs 34% p = 0.008) and an increase in cough (63% vs 17% p < 0.001) in the VOC compared to WT groups was observed. Analysis of the frequency of individual symptoms showed significantly lower frequency of both chest pain (25% vs 39% p = 0.004) and palpitations (12% vs 32% p < 0.001) in the VOC group compared to the WT group. In adjusted analysis being in the VOC group was significantly associated with a lower odds of both chest pain and palpitations, but vaccination was not associated with these symptoms.
Conclusion: This study suggests changes in long COVID phenotype in individuals infected later in the pandemic, with less palpitations and chest pain reported. Adjusted analyses suggest that these effects are mediated through introduction of variants rather than an effect from vaccination.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje