Post-COVID Syndrome (PCS) after Omicron infection in vaccinated individuals is less characterized than in unvaccinated or earlier-variant cohorts. We aimed to estimate PCS incidence, symptom trajectories, and risk factors over 18 months.
Methods: The COVE-LATE study prospectively followed 12,892 adults (≥18 years, ≥2 mRNA vaccine doses) who had a laboratory-confirmed Omicron (BA.5 sublineage) infection between January–June 2023. PCS was defined as ≥1 new or worsening symptom persisting >12 weeks post-infection not explained by an alternative diagnosis. Outcomes were assessed via monthly surveys and electronic health record linkage.
Findings: At 12 weeks, 14.3% (95% CI 13.6–15.0) met PCS criteria, declining to 8.2% (7.6–8.8) at 18 months. The most common persistent symptoms were fatigue (68% of PCS cases), cognitive dysfunction (“brain fog”; 54%), and exertional malaise (41%). Female sex (HR 1.64, p<0.001), pre-existing anxiety or depression (HR 2.01, p<0.001), and acute infection severity requiring any medical attention (HR 1.43, p=0.008) independently predicted non-resolution at 18 months. Reinfections during follow-up were associated with worsening of existing PCS symptoms in 37% of cases.
Interpretation: PCS following Omicron in vaccinated adults is less common than in pre-Omicron eras but still affects approximately 1 in 12 individuals beyond 12 months. Persistent cases exhibit a distinct symptom cluster dominated by neurocognitive and energy-limiting features. Targeted rehabilitation and re-infection prevention remain priorities.
Research Notes:
Methodology: Large prospective cohort; robust baseline (pre-infection) health data; rigorous definition of PCS excluding alternative diagnoses.
Limitation: Self-reported symptoms; potential survivor bias (severe acute cases were a small fraction).
Funding: European Union Horizon Europe and the Coalition for Epidemic Preparedness Innovations (CEPI).
No comments:
Post a Comment