학술논문
Infection with SARS-CoV-2 Variants Is Associated with Different Long COVID Phenotypes
Document Type
article
Author
Michele Spinicci; Lucia Graziani; Marta Tilli; Jerusalem Nkurunziza; Iacopo Vellere; Beatrice Borchi; Jessica Mencarini; Irene Campolmi; Leonardo Gori; Lorenzo Giovannoni; Carla Amato; Luca Livi; Laura Rasero; Francesco Fattirolli; Rossella Marcucci; Betti Giusti; Iacopo Olivotto; Sara Tomassetti; Federico Lavorini; Laura Maggi; Francesco Annunziato; Niccolò Marchionni; Lorenzo Zammarchi; Alessandro Bartoloni
Source
Viruses, Vol 14, Iss 11, p 2367 (2022)
Subject
Language
English
ISSN
1999-4915
Abstract
COVID-19 has been associated with a broad range of long-term sequelae, commonly referred to as “long-COVID” or “post-COVID-19” syndrome. Despite an increasing body of literature, long COVID remains poorly characterized. We retrospectively analysed data from electronic medical records of patients admitted to the post-COVID-19 outpatient service of the Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy, between June 2020 and June 2021, 4–12 weeks after hospital discharge. A total of 428 patients, 41% women, median age 64 years, underwent a follow-up visit a median 53 days after hospital discharge. Overall, 76% patients reported at least one persistent symptom, including dyspnoea (37%), chronic fatigue (36%), insomnia (16%), visual disorders (13%) and brain fog (13%). Increasing oxygen support (OR 1.4, 95% CI 1.1–1.8), use of immunosuppressants (OR 6.4, 95% CI 1.5–28) and female sex (OR 1.8, 95% CI 1.1–2.9) were associated with a higher risk of long COVID symptoms. Comparison between symptomatic patients infected in the period March–December 2020 (prevalent circulation of wild-type SARS-CoV-2) with those infected in the period January–April 2021 (prevalent circulation of B.1.1.7 Alpha variant) showed a significant modification in the pattern of symptoms belonging to the neurological and cognitive/emotional categories. Our findings confirmed shortness of breath and chronic fatigue as the most frequent long COVID manifestations, while female sex and severe COVID-19 course were the main risk factors for developing lingering symptoms. SARS-CoV-2 variants may induce different long COVID phenotypes, possibly due to changes in cell tropism and differences in viral–host interaction.