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Post-acute sequelae of SARS-CoV-2 with clinical condition definitions and comparison in a matched cohort

Michael A. Horberg, Eric Watson, Mamta Bhatia, Celeena Jefferson, Julia M. Certa, Seohyun Kim, Lily Fathi, Keri N. Althoff, Carolyn Williams, Richard Moore

2022Nature Communications44 citationsDOIOpen Access PDF

Abstract

Disease characterization of Post-Acute Sequelae of SARS-CoV-2 (PASC) does not account for pre-existing conditions and time course of incidence. We utilized longitudinal data and matching to a COVID PCR-negative population to discriminate PASC conditions over time within our patient population during 2020. Clinical Classification Software was used to identify PASC condition groupings. Conditions were specified acute and persistent (occurring 0-30 days post COVID PCR and persisted 30-120 days post-test) or late (occurring initially 30-120 days post-test). We matched 3:1 COVID PCR-negative COVIDPCR-positive by age, sex, testing month and service area, controlling for pre-existing conditions up to four years prior; 28,118 PCR-positive to 70,293 PCR-negative patients resulted. We estimated PASC risk from the matched cohort. Risk of any PASC condition was 12% greater for PCR-positive patients in the late period with a significantly higher risk of anosmia, cardiac dysrhythmia, diabetes, genitourinary disorders, malaise, and nonspecific chest pain. Our findings contribute to a more refined PASC definition which can enhance clinical care.

Topics & Concepts

CohortSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Sars virusCoronavirus disease 2019 (COVID-19)MedicineCohort study2019-20 coronavirus outbreakIntensive care medicineVirologyInternal medicineDiseaseOutbreakInfectious disease (medical specialty)Long-Term Effects of COVID-19COVID-19 Clinical Research StudiesInfectious Encephalopathies and Encephalitis