Abstract
Background: The incidence of persistent clinical symptoms and risk factors in Post-Acute Sequelae of SARS-CoV-2 (PASC) in diverse US cohorts is unclear. While there are a disproportionate share of COVID-19 deaths in older patients, ethnic minorities, and socially disadvantaged populations in the USA, little information is available on the association of these factors and PASC.
Objective: To evaluate the association of demographic and clinical characteristics with development of PASC.
Design: Prospective observational cohort of hospitalized and high-risk outpatients, April 2020 to February 2021.
Participants: One thousand thirty-eight adults with laboratory-confirmed symptomatic COVID-19 infection.
Main measures: Development of PASC determined by patient report of persistent symptoms on questionnaires conducted 60 or 90 days after COVID-19 infection or hospital discharge. Demographic and clinical factors associated with PASC.
Key results: Of 1,038 patients with longitudinal follow-up, 309 patients (29.8%) developed PASC. The most common persistent symptom was fatigue (31.4%) followed by shortness of breath (15.4%) in hospitalized patients and anosmia (15.9%) in outpatients. Hospitalization for COVID-19 (odds ratio [OR] 1.49, 95% [CI] 1.04-2.14), having diabetes (OR, 1.39; 95% CI 1.02-1.88), and higher BMI (OR, 1.02; 95% CI 1-1.04) were independently associated with PASC. Medicaid compared to commercial insurance (OR, 0.49; 95% CI 0.31-0.77) and having had an organ transplant (OR 0.44, 95% CI, 0.26-0.76) were inversely associated with PASC. Age, race/ethnicity, Social Vulnerability Index, and baseline functional status were not associated with developing PASC.
Conclusions: Three in ten survivors with COVID-19 developed a subset of symptoms associated with PASC in our cohort. While ethnic minorities, older age, and social disadvantage are associated with worse acute COVID-19 infection and greater risk of death, our study found no association between these factors and PASC.
【초록키워드】 COVID-19, SARS-CoV-2, Hospitalized, fatigue, Clinical characteristics, Infection, Organ transplant, Symptom, risk factor, Population, Anosmia, Cohort, COVID-19 infection, symptomatic, vulnerability, Prospective, Patient, Older age, death, outpatients, Follow-up, incidence, BMI, PASC, USA, demographic, information, development, questionnaire, association, older patients, Odds ratio, Shortness of breath, risk of death, index, Factor, Medicaid, 95% CI, clinical symptom, hospital discharge, acute COVID-19, laboratory-confirmed, while, survivor, greater, evaluate, conducted, functional, hospitalized patient, subset, diabete, baseline, clinical factor, with COVID-19, 【제목키워드】 COVID-19, SARS-CoV-2, PASC, Outpatient, Inpatient, Factor, setting,