TY - JOUR
T1 - Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection
AU - Thaweethai, Tanayott
AU - Jolley, Sarah E.
AU - Karlson, Elizabeth W.
AU - Levitan, Emily B.
AU - Levy, Bruce
AU - McComsey, Grace A.
AU - McCorkell, Lisa
AU - Nadkarni, Girish N.
AU - Parthasarathy, Sairam
AU - Singh, Upinder
AU - Walker, Tiffany A.
AU - Selvaggi, Caitlin A.
AU - Shinnick, Daniel J.
AU - Schulte, Carolin C. M.
AU - Atchley-Challenner, Rachel
AU - Horwitz, Leora I.
AU - Foulkes, Andrea S.
AU - Aberg, Judith A.
AU - Adolphi, Natalie L.
AU - Ahirwar, Shreya
AU - Ahmed, Shifa
AU - Ahuja, Neera
AU - Aikawa, Masanori
AU - Akerlundh, Almary
AU - Akintonwa, Teresa T.
AU - Al-Jadiri, Aseel
AU - Alekhina, Natalya
AU - Algren, Heather A.
AU - Alshawabkeh, Akram N.
AU - Ammar, Nariman
AU - Anand, Adit
AU - Anderson, Brett R.
AU - Aponte-Soto, Lisa
AU - Aschner, Judy L.
AU - Atha, Mary M.
AU - Atz, Andrew M.
AU - Aupperle, Robin L.
AU - Ayache, Mirna
AU - Azziz-Baumgartner, Eduardo
AU - Bailey, L. C.
AU - Baker, Fiona C.
AU - Balaraman, Venkataraman
AU - Bandy, Jennifer A.
AU - Banerjee, Dithi
AU - Barch, Deanna M.
AU - Bardes, James M.
AU - Barlocker, Jackson
AU - Barr, R. G.
AU - Baskin-Sommers, Arielle
AU - Basu, Sanjib
AU - Battaglia, Tracy A.
PY - 2023/6/13
Y1 - 2023/6/13
N2 - Importance: SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals.ObjectiveTo develop a definition of PASC using self-reported symptoms and describe PASC frequencies across cohorts, vaccination status, and number of infections.Design, Setting, and Participants: Prospective observational cohort study of adults with and without SARS-CoV-2 infection at 85 enrolling sites (hospitals, health centers, community organizations) located in 33 states plus Washington, DC, and Puerto Rico. Participants who were enrolled in the RECOVER adult cohort before April 10, 2023, completed a symptom survey 6 months or more after acute symptom onset or test date. Selection included population-based, volunteer, and convenience sampling.Exposure: SARS-CoV-2 infection.Main Outcomes and Measures: PASC and 44 participant-reported symptoms (with severity thresholds).Results: A total of 9764 participants (89% SARS-CoV-2 infected; 71% female; 16% Hispanic/Latino; 15% non-Hispanic Black; median age, 47 years [IQR, 35-60]) met selection criteria. Adjusted odds ratios were 1.5 or greater (infected vs uninfected participants) for 37 symptoms. Symptoms contributing to PASC score included postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements. Among 2231 participants first infected on or after December 1, 2021, and enrolled within 30 days of infection, 224 (10% [95% CI, 8.8%-11%]) were PASC positive at 6 months. Conclusions and Relevance:A definition of PASC was developed based on symptoms in a prospective cohort study. As a first step to providing a framework for other investigations, iterative refinement that further incorporates other clinical features is needed to support actionable definitions of PASC.
AB - Importance: SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals.ObjectiveTo develop a definition of PASC using self-reported symptoms and describe PASC frequencies across cohorts, vaccination status, and number of infections.Design, Setting, and Participants: Prospective observational cohort study of adults with and without SARS-CoV-2 infection at 85 enrolling sites (hospitals, health centers, community organizations) located in 33 states plus Washington, DC, and Puerto Rico. Participants who were enrolled in the RECOVER adult cohort before April 10, 2023, completed a symptom survey 6 months or more after acute symptom onset or test date. Selection included population-based, volunteer, and convenience sampling.Exposure: SARS-CoV-2 infection.Main Outcomes and Measures: PASC and 44 participant-reported symptoms (with severity thresholds).Results: A total of 9764 participants (89% SARS-CoV-2 infected; 71% female; 16% Hispanic/Latino; 15% non-Hispanic Black; median age, 47 years [IQR, 35-60]) met selection criteria. Adjusted odds ratios were 1.5 or greater (infected vs uninfected participants) for 37 symptoms. Symptoms contributing to PASC score included postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements. Among 2231 participants first infected on or after December 1, 2021, and enrolled within 30 days of infection, 224 (10% [95% CI, 8.8%-11%]) were PASC positive at 6 months. Conclusions and Relevance:A definition of PASC was developed based on symptoms in a prospective cohort study. As a first step to providing a framework for other investigations, iterative refinement that further incorporates other clinical features is needed to support actionable definitions of PASC.
UR - http://dx.doi.org/10.1001/jama.2023.8823
U2 - 10.1001/jama.2023.8823
DO - 10.1001/jama.2023.8823
M3 - Article
C2 - 37278994
SN - 0098-7484
JO - JAMA
JF - JAMA
ER -