Association between SARS-CoV-2 infection and select symptoms and conditions 31 to 150 days after testing among children and adults
Zhang, Y; Romieu-Hernandez, A; Boehmer, TK; et al., BMC Infectious Diseases
Published
February 2024
Journal
BMC Infectious Diseases
Abstract
Background: An increasing number of studies have described new and persistent symptoms and conditions as potential post-acute sequelae of SARS-CoV-2 infection (PASC). However, it remains unclear whether certain symptoms or conditions occur more frequently among persons with SARS-CoV-2 infection compared with those never infected with SARS-CoV-2. We compared the occurrence of specific COVID-associated symptoms and conditions as potential PASC 31- to 150-day following a SARS-CoV-2 test among adults and children with positive and negative test results. Methods: We conducted a retrospective cohort study using electronic health record (EHR) data from 43 PCORnet sites participating in a national COVID-19 surveillance program. This study included 3,091,580 adults (316,249 SARS-CoV-2 positive; 2,775,331 negative) and 675,643 children (62,131 positive; 613,512 negative) who had a SARS-CoV-2 laboratory test during March 1, 2020-May 31, 2021 documented in their EHR. We used logistic regression to calculate the odds of having a symptom and Cox models to calculate the risk of having a newly diagnosed condition associated with a SARS-CoV-2 positive test. Results: After adjustment for baseline covariates, hospitalized adults and children with a positive test had increased odds of being diagnosed with ≥ 1 symptom (adults: adjusted odds ratio[aOR], 1.17[95% CI, 1.11-1.23]; children: aOR, 1.18[95% CI, 1.08-1.28]) or shortness of breath (adults: aOR, 1.50[95% CI, 1.38-1.63]; children: aOR, 1.40[95% CI, 1.15-1.70]) 31-150 days following a SARS-CoV-2 test compared with hospitalized individuals with a negative test. Hospitalized adults with a positive test also had increased odds of being diagnosed with ≥ 3 symptoms or fatigue compared with those testing negative. The risks of being newly diagnosed with type 1 or type 2 diabetes (adjusted hazard ratio[aHR], 1.25[95% CI, 1.17-1.33]), hematologic disorders (aHR, 1.19[95% CI, 1.11-1.28]), or respiratory disease (aHR, 1.44[95% CI, 1.30-1.60]) were higher among hospitalized adults with a positive test compared with those with a negative test. Non-hospitalized adults with a positive test also had higher odds or increased risk of being diagnosed with certain symptoms or conditions. Conclusions: Patients with SARS-CoV-2 infection, especially those who were hospitalized, were at higher risk of being diagnosed with certain symptoms and conditions after acute infection.
Authors
Yongkang Zhang, Alfonso Romieu-Hernandez, Tegan K Boehmer, Eduardo Azziz-Baumgartner, Thomas W Carton, Adi V Gundlapalli, Julia Fearrington, Kshema Nagavedu, Katherine Dea, Erick Moyneur, Lindsay G Cowell, Rainu Kaushal, Kenneth H Mayer, Jon Puro, Sonja A Rasmussen, Deepika Thacker, Mark G Weiner, Sharon Saydah, Jason P Block; PCORnet Network Partners
Keywords
COVID-19 pandemic; Electronic health record; Long-COVID; SARS-CoV-2
Short Summary
This RECOVER study looked at why some people may have long lasting symptoms or new health problems after getting COVID-19. Researchers looked at the electronic health records of 3.7 million adults and children who were tested for COVID between March 2020 and May 2021. They compared the records of people who tested positive for COVID with people who did not.
The study found that both adults and children who were hospitalized with COVID were more likely to have at least 1 symptom in the months after getting COVID, like shortness of breath. They also found that adults who were hospitalized with COVID were more likely to have 3 or more symptoms, feel very tired, or develop a new health condition. Some of the conditions were diabetes, blood disorders, or diseases related to breathing. Even adults with COVID who were not hospitalized had a higher chance of certain symptoms or health issues compared to those who did not have COVID. This study is important because it shows that COVID can impact people’s health for a long time, even after their first infection is gone. These findings can help doctors and scientists better understand how to treat and care for people recovering from COVID.