1. Post-COVID symptom profiles and duration in a global convalescent COVID-19 observational cohort: Correlations with demographics, medical history, acute COVID-19 severity and global region.
- Author
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Karuna, Shelly, Gallardo-Cartagena, Jorge A., Theodore, Deborah, Hunidzarira, Portia, Montenegro-Idrogo, Juan, Jiani Hu, Jones, Megan, Kim, Vicky, De La Grecca, Robert, Trahey, Meg, Karg, Carissa, Takalani, Azwi, Polakowski, Laura, Hutter, Julia, Miner, Maurine D., Erdmann, Nathan, Goepfert, Paul, Maboa, Rebone, Corey, Lawrence, and Gill, Katherine
- Subjects
RESEARCH ,KRUSKAL-Wallis Test ,COVID-19 ,SCIENTIFIC observation ,CONFIDENCE intervals ,POST-acute COVID-19 syndrome ,CONVALESCENCE ,SEVERITY of illness index ,COMPARATIVE studies ,DISEASE duration ,QUALITY of life ,RESEARCH funding ,DESCRIPTIVE statistics ,CHI-squared test ,KAPLAN-Meier estimator ,SOCIODEMOGRAPHIC factors ,LOGISTIC regression analysis ,STATISTICAL correlation ,ODDS ratio ,DATA analysis software ,COVID-19 testing ,LONGITUDINAL method ,SYMPTOMS ,ADULTS - Abstract
Background Post-COVID conditions are characterised by persistent symptoms that negatively impact quality of life after SARS-CoV-2 diagnosis. While post-COVID risk factors and symptoms have been extensively described in localised regions, especially in the global north, post-COVID conditions remain poorly understood globally. The global, observational cohort study HVTN 405/HPTN 1901 characterises the convalescent course of SARS-CoV-2 infection among adults in North and South America and Africa. Methods We categorised the cohort by infection severity (asymptomatic, symptomatic, no oxygen requirement (NOR), non-invasive oxygen requirement (NIOR), invasive oxygen requirement (IOR)). We applied a regression model to assess correlations of demographics, co-morbidities, disease severity, and concomitant medications with COVID-19 symptom persistence and duration across global regions. Results We enrolled 759 participants from Botswana, Malawi, South Africa, Zambia, Zimbabwe, Peru, and the USA a median of 51 (interquartile range (IQR)=35-66) days post-diagnosis, from May 2020 to March 2021. 53.8% were female, 69.8% were 18-55 years old (median (md)=44 years old, IQR=33-58). Comorbidities included obesity (42.8%), hypertension (24%), diabetes (14%), human immunodeficiency virus (HIV) infection (11.6%) and lung disease (7.5%). 76.2% were symptomatic (NOR=47.4%; NIOR=22.9%; IOR=5.8%). Median COVID-19 duration among symptomatic participants was 20 days (IQR=11-35); 43.4% reported symptoms after COVID-19 resolution, 33.6% reported symptoms ≥30 days, 9.9% reported symptoms ≥60 days. Symptom duration correlated with disease severity (P<0.001, NIOR vs NOR; P=0.003, IOR vs NOR), lung disease (P=0.001), race (P<0.05, non-Hispanic Black vs White), and global region (P<0.001). Prolonged viral shedding correlated with persistent abdominal pain (odds ratio (OR) = 5.51, P < 0.05) and persistent diarrhoea (OR=6.64, P<0.01). Conclusions Post-COVID duration varied with infection severity, race, lung disease, and region. Better understanding post-COVID conditions, including regionally-diverse symptom profiles, may improve clinical assessment and management globally. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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