학술논문
Refining "Long-COVID" by a Prospective Multimodal Evaluation of Patients with Long-Term Symptoms Attributed to SARS-CoV-2 Infection.
Document Type
Article
Author
Scherlinger, Marc; Felten, Renaud; Gallais, Floriane; Nazon, Charlotte; Chatelus, Emmanuel; Pijnenburg, Luc; Mengin, Amaury; Gras, Adrien; Vidailhet, Pierre; Arnould-Michel, Rachel; Bibi-Triki, Sabrina; Carapito, Raphaël; Trouillet-Assant, Sophie; Perret, Magali; Belot, Alexandre; Bahram, Seiamak; Arnaud, Laurent; Gottenberg, Jacques-Eric; Fafi-Kremer, Samira; Sibilia, Jean
Source
Subject
*POST-acute COVID-19 syndrome
*SARS-CoV-2
*COUGH
*COVID-19
*IMMUNOASSAY
*POST-traumatic stress disorder
*
*
*
*
*
Language
ISSN
2193-8229
Abstract
Introduction: COVID-19 long-haulers, also decribed as having "long-COVID" or post-acute COVID-19 syndrome, represent 10% of COVID-19 patients and remain understudied. Methods: In this prospective study, we recruited 30 consecutive patients seeking medical help for persistent symptoms (> 30 days) attributed to COVID-19. All reported a viral illness compatible with COVID-19. The patients underwent a multi-modal evaluation, including clinical, psychologic, virologic and specific immunologic assays and were followed longitudinally. A group of 17 convalescent COVID-19 individuals without persistent symptoms were included as a comparison group. Results: The median age was 40 [interquartile range: 35–54] years and 18 (60%) were female. At a median time of 152 [102–164] days after symptom onset, fever, cough and dyspnea were less frequently reported compared with the initial presentation, but paresthesia and burning pain emerged in 18 (60%) and 13 (43%) patients, respectively. The clinical examination was unremarkable in all patients, although the median fatigue and pain visual analog scales were 7 [5–8] and 5 [2–6], respectively. Extensive biologic studies were unremarkable, and multiplex cytokines and ultra-sensitive interferon-α2 measurements were similar between long-haulers and convalescent COVID-19 individuals without persistent symptoms. Using SARS-CoV-2 serology and IFN-γ ELISPOT, we found evidence of a previous SARS-CoV-2 infection in 50% (15/30) of patients, with evidence of a lack of immune response, or a waning immune response, in two patients. Finally, psychiatric evaluation showed that 11 (36.7%), 13 (43.3%) and 9 (30%) patients had a positive screening for anxiety, depression and post-traumatic stress disorder, respectively. Conclusions: Half of patients seeking medical help for post-acute COVID-19 syndrome lack SARS-CoV-2 immunity. The presence of SARS-CoV-2 immunity, or not, had no consequence on the clinical or biologic characteristics of post-acute COVID-19 syndrome patients, all of whom reported severe fatigue, altered quality of life and psychologic distress. [ABSTRACT FROM AUTHOR]