Association Between SARS-CoV-2 Variants and Frequency of Acute Symptoms: Analysis of a Multi-institutional Prospective Cohort Study—December 20, 2020—June 20, 2022
Ralph C. Wang, Michael Gottlieb, Juan Carlos C. Montoy, Robert M. Rodriguez, Huihui Yu, Erica S. Spatz, Christopher W Chandler, Joann G. Elmore, Paavali Hannikainen, Anna Marie Chang, Mandy J. Hill, Ryan Huebinger, Ahamed H. Idris, Katherine Koo, Shu‐Xia Li, Samuel McDonald, Graham Nichol, Kelli N. O’Laughlin, Ian D. Plumb, Michelle Santangelo, Sharon Saydah, Kari A. Stephens, Arjun K. Venkatesh, Robert A. Weinstein, Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) Group, Robert A. Weinstein, Michael Gottlieb, Michelle Santangelo, Katherine Koo, Antonia Derden, Michael Gottlieb, Kristyn Gatling, Diego Cordero, Geoffrey Yang, Marshall Kaadan, Minna Hassaballa, Ryan Jerger, Zohaib Ahmed, Michael Choi, Arjun K. Venkatesh, Erica S. Spatz, Zhenqiu Lin, Shu‐Xia Li, Huihui Yu, Mengni Liu, Arjun K. Venkatesh, Erica S. Spatz, Andrew Ulrich, Jeremiah Kinsman, Jocelyn Dorney, Senyte Pierce, Xavier Puente, Graham Nichol, Kari A. Stephens, Jill Anderson, Dana Morse, Karen Adams, Zenoura Maat, Tracy Stober, Kelli N O’Laughlin, Nikki Gentile, Rachel E Geyer, Michael Willis, Luis Ruiz, Kerry Malone, Jasmine Park, Kristin L. Rising, Efrat Kean, Morgan Kelly, Kevin Schaeffer, Paavali Hannikainen, Lindsey Shughart, Hailey Shughart, Nicole Renzi, Grace Amadio, Dylan Grau, Phillip B. Watts, David Cheng, Jessica Miao, Carly Shutty, Alex Charlton, Mandy J. Hill, Ryan Huebinger Site, Summer Chavez, Arun Kane, Peter Nikonowicz, Ahamed H Idris, Samuel McDonald, David Gallegos, Riley Martin, Joann G. Elmore, Lauren E. Wisk, Michelle L’Hommedieu, Chris Chandler, Megan Eguchi, Kate Diaz Roldan, Nicole Villegas, Raul Moreno, Robert M. Rodriguez, Ralph C. Wang
Abstract
Abstract Background While prior work examining severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern focused on hospitalization and death, less is known about differences in clinical presentation. We compared the prevalence of acute symptoms across pre-Delta, Delta, and Omicron. Methods We conducted an analysis of the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), a cohort study enrolling symptomatic SARS-CoV-2-positive participants. We determined the association between the pre-Delta, Delta, and Omicron time periods and the prevalence of 21 coronavirus disease 2019 (COVID-19) acute symptoms. Results We enrolled 4113 participants from December 2020 to June 2022. Pre-Delta vs Delta vs Omicron participants had increasing sore throat (40.9%, 54.6%, 70.6%; P < .001), cough (50.9%, 63.3%, 66.7%; P < .001), and runny noses (48.9%, 71.3%, 72.9%; P < .001). We observed reductions during Omicron in chest pain (31.1%, 24.2%, 20.9%; P < .001), shortness of breath (42.7%, 29.5%, 27.5%; P < .001), loss of taste (47.1%, 61.8%, 19.2%; P < .001), and loss of smell (47.5%, 55.6%, 20.0%; P < .001). After adjustment, those infected during Omicron had significantly higher odds of sore throat vs pre-Delta (odds ratio [OR], 2.76; 95% CI, 2.26–3.35) and Delta (OR, 1.96; 95% CI, 1.69–2.28). Conclusions Participants infected during Omicron were more likely to report symptoms of common respiratory viruses, such as sore throat, and less likely to report loss of smell and taste. Trial registration NCT04610515.