Longitudinal clinical phenotyping of post COVID condition in Mexican adults recovering from severe COVID-19: a prospective cohort study
Isaac Núñez, Joshua Gillard, Sergio Fragoso-Saavedra, Dorien Feyaerts, León Islas-Weinstein, Angel A. Gallegos-Guzmán, Uriel Valente-García, Justin Meyerowitz, J. Daniel Kelly, Han Chen, Edward A. Ganio, Alexander Benkendorff, Jaime Flores‐Gouyonnet, Pedro Dammann-Beltrán, José Francisco Heredia-González, Gabriela A. Rangel-Gutiérrez, Catherine A. Blish, Kari C. Nadeau, Garry P. Nolan, José C. Crispín, David R. McIlwain, Brice Gaudillière, Sergio Iván Valdés‐Ferrer
Abstract
Introduction: Few studies have evaluated the presence of Post COVID-19 conditions (PCC) in people from Latin America, a region that has been heavily afflicted by the COVID-19 pandemic. In this study, we describe the frequency, co-occurrence, predictors, and duration of 23 symptoms in a cohort of Mexican patients with PCC. Methods: We prospectively enrolled and followed adult patients hospitalized for severe COVID-19 at a tertiary care centre in Mexico City. The incidence of PCC symptoms was determined using questionnaires. Unsupervised clustering of PCC symptom co-occurrence and Kaplan-Meier analyses of symptom persistence were performed. The effect of baseline clinical characteristics was evaluated using Cox regression models and reported with hazard ratios (HR). Results: We found that amongst 192 patients with PCC, respiratory problems were the most prevalent and commonly co-occurred with functional activity impairment. 56% had ≥5 persistent symptoms. Symptom persistence probability at 360 days 0.78. Prior SARS-CoV-2 vaccination and infection during the Delta variant wave were associated with a shorter duration of PCC. Male sex was associated with a shorter duration of functional activity impairment and respiratory symptoms. Hypertension and diabetes were associated with a longer duration of functional impairment. Previous vaccination accelerated PCC recovery. Discussion: In our cohort, PCC symptoms were frequent (particularly respiratory and neurocognitive ones) and persistent. Importantly, prior SARS-CoV-2 vaccination resulted in a shorter duration of PCC.