TY - JOUR
T1 - Antecedent and persistent symptoms in COVID-19 and other respiratory illnesses
T2 - insights from prospectively collected data in the BRACE trial
AU - McDonald, Ellie
AU - Pittet, Laure F
AU - Barry, Simone E
AU - Bonten, Marc
AU - Campbell, John
AU - Croda, Julio
AU - Croda, Mariana G
AU - Dalcolmo, Margareth Pretti
AU - Davidson, Andrew
AU - de Almeida E Val, Fernando F
AU - Dos Santos, Ms Glauce
AU - Gardiner, Ms Kaya
AU - Gell, Ms Grace
AU - Gwee, Amanda
AU - Krastev, Ms Ann
AU - Lacerda, Marcus Vinícius Guimaraes
AU - Lucas, Michaela
AU - Lynn, David J
AU - Manning, Laurens
AU - McPhate, Mr Nick
AU - Perrett, Kirsten P
AU - Post, Jeffrey J
AU - Prat-Aymerich, Cristina
AU - Quinn, Ms Lynne E
AU - Richmond, Peter C
AU - Wood, Nicholas J
AU - Messina, Nicole L
AU - Curtis, Nigel
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/11
Y1 - 2024/11
N2 - Background: Some individuals have a persistence of symptoms following both COVID-19 (post-acute COVID-19 syndrome; PACS) and other viral infections. This study used prospectively collected data from an international trial to compare symptoms following COVID-19 and non-COVID-19 respiratory illness, to identify factors associated with the risk of PACS, and to explore symptom patterns before and after COVID-19 and non-COVID-19 respiratory illnesses. Methods: Data from a multicentre randomised controlled trial (BRACE trial) involving healthcare workers across four countries were analysed. Symptom data were prospectively collected over 12 months, allowing detailed characterisation of symptom patterns. Participants with COVID-19 and non-COVID-19 respiratory illness episodes were compared, focussing on symptom severity, duration (including PACS using NICE and WHO definitions), and pre-existing symptoms. Findings: Compared to those with a non-COVID-19 illness, participants with COVID-19 had significantly more severe illness (OR 7·4, 95%CI 5·6–9·7). Symptom duration meeting PACS definitions occurred in a higher proportion of COVID-19 cases than non-COVID-19 respiratory controls using both the NICE definition (2·5% vs 0·5%, OR 6·6, 95%CI 2·4–18·3) and the WHO definition (8·8% vs 3·7%, OR 2·5, 95%CI 1·4–4·3). When considering only participants with COVID-19, age 40-59 years (aOR 2·8, 95%CI 1·3–6·2), chronic respiratory disease (aOR 5·5, 95%CI 1·3–23·1), and pre-existing symptoms (aOR 3·0, 95%CI 1·4–6·3) were associated with an increased risk of developing PACS. Symptoms associated with PACS were also reported by participants in the months preceding their COVID-19 or non-COVID-19 respiratory illnesses (32% fatigue and muscle ache, 11% intermittent cough and shortness of breath). Interpretation: Healthcare workers with COVID-19 were more likely to have severe and longer-lasting symptoms than those with a non-COVID-19 respiratory illness, with a higher proportion meeting the WHO or NICE definitions of PACS. Age, chronic respiratory disease, and pre-existing symptoms increased the risk of developing PACS following COVID-19.
AB - Background: Some individuals have a persistence of symptoms following both COVID-19 (post-acute COVID-19 syndrome; PACS) and other viral infections. This study used prospectively collected data from an international trial to compare symptoms following COVID-19 and non-COVID-19 respiratory illness, to identify factors associated with the risk of PACS, and to explore symptom patterns before and after COVID-19 and non-COVID-19 respiratory illnesses. Methods: Data from a multicentre randomised controlled trial (BRACE trial) involving healthcare workers across four countries were analysed. Symptom data were prospectively collected over 12 months, allowing detailed characterisation of symptom patterns. Participants with COVID-19 and non-COVID-19 respiratory illness episodes were compared, focussing on symptom severity, duration (including PACS using NICE and WHO definitions), and pre-existing symptoms. Findings: Compared to those with a non-COVID-19 illness, participants with COVID-19 had significantly more severe illness (OR 7·4, 95%CI 5·6–9·7). Symptom duration meeting PACS definitions occurred in a higher proportion of COVID-19 cases than non-COVID-19 respiratory controls using both the NICE definition (2·5% vs 0·5%, OR 6·6, 95%CI 2·4–18·3) and the WHO definition (8·8% vs 3·7%, OR 2·5, 95%CI 1·4–4·3). When considering only participants with COVID-19, age 40-59 years (aOR 2·8, 95%CI 1·3–6·2), chronic respiratory disease (aOR 5·5, 95%CI 1·3–23·1), and pre-existing symptoms (aOR 3·0, 95%CI 1·4–6·3) were associated with an increased risk of developing PACS. Symptoms associated with PACS were also reported by participants in the months preceding their COVID-19 or non-COVID-19 respiratory illnesses (32% fatigue and muscle ache, 11% intermittent cough and shortness of breath). Interpretation: Healthcare workers with COVID-19 were more likely to have severe and longer-lasting symptoms than those with a non-COVID-19 respiratory illness, with a higher proportion meeting the WHO or NICE definitions of PACS. Age, chronic respiratory disease, and pre-existing symptoms increased the risk of developing PACS following COVID-19.
KW - Age
KW - COVID-19
KW - Chronic respiratory disease
KW - Healthcare workers
KW - Long COVID
KW - Multicentre study
KW - Non-COVID-19 respiratory illness
KW - Persistent symptoms
KW - Post-acute COVID-19 syndrome (PACS)
KW - Pre-existing symptoms
KW - Prospective data
KW - Symptom duration
KW - Symptom patterns
KW - Symptom severity
UR - http://www.scopus.com/inward/record.url?scp=85204806212&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2024.106267
DO - 10.1016/j.jinf.2024.106267
M3 - Article
C2 - 39245151
SN - 0163-4453
VL - 89
JO - The Journal of Infection
JF - The Journal of Infection
IS - 5
M1 - 106267
ER -