학술논문
Post-Acute Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection by Viral Variant and Vaccination Status: A Multicenter Cross-Sectional Study.
Document Type
Article
Author
Kahlert, Christian R; Strahm, Carol; Güsewell, Sabine; Cusini, Alexia; Brucher, Angela; Goppel, Stephan; Möller, Elisabeth; Möller, J Carsten; Ortner, Manuela; Ruetti, Markus; Stocker, Reto; Vuichard-Gysin, Danielle; Besold, Ulrike; McGeer, Allison; Risch, Lorenz; Friedl, Andrée; Schlegel, Matthias; Vernazza, Pietro; Kuster, Stefan P; Kohler, Philipp
Source
Subject
*RESEARCH
*COVID-19
*CONFIDENCE intervals
*POST-acute COVID-19 syndrome
*SICK people
*COVID-19 vaccines
*CROSS-sectional method
*SELF-evaluation
*MEDICAL personnel
*REGRESSION analysis
*VACCINE effectiveness
*RISK assessment
*RESEARCH funding
*DESCRIPTIVE statistics
*VACCINATION status
*ODDS ratio
*LONGITUDINAL method
*DISEASE risk factors
*SYMPTOMS
*EVALUATION
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Language
ISSN
1058-4838
Abstract
Background Disentangling the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and vaccination on the occurrence of post-acute sequelae of SARS-CoV-2 (PASC) is crucial to estimate and reduce the burden of PASC. Methods We performed a cross-sectional analysis (May/June 2022) within a prospective multicenter healthcare worker (HCW) cohort in north-eastern Switzerland. HCWs were stratified by viral variant and vaccination status at time of their first positive SARS-CoV-2 nasopharyngeal swab. HCWs without positive swab and with negative serology served as controls. The sum of 18 self-reported PASC symptoms was modeled with univariable and multivariable negative-binomial regression to analyze the association of mean symptom number with viral variant and vaccination status. Results Among 2912 participants (median age: 44 years; 81.3% female), PASC symptoms were significantly more frequent after wild-type infection (estimated mean symptom number: 1.12; P <.001; median time since infection: 18.3 months), after Alpha/Delta infection (0.67 symptoms; P <.001; 6.5 months), and after Omicron BA.1 infections (0.52 symptoms; P =.005; 3.1 months) versus uninfected controls (0.39 symptoms). After Omicron BA.1 infection, the estimated mean symptom number was 0.36 for unvaccinated individuals versus 0.71 with 1–2 vaccinations (P =.028) and 0.49 with ≥3 prior vaccinations (P =.30). Adjusting for confounders, only wild-type (adjusted rate ratio [aRR]: 2.81; 95% confidence interval [CI]: 2.08–3.83) and Alpha/Delta infections (aRR: 1.93; 95% CI: 1.10–3.46) were significantly associated with the outcome. Conclusions Previous infection with pre-Omicron variants was the strongest risk factor for PASC symptoms among our HCWs. Vaccination before Omicron BA.1 infection was not associated with a clear protective effect against PASC symptoms in this population. [ABSTRACT FROM AUTHOR]