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 - Alba, George A.
AU - Alicic, Radica
AU - Altman, Natasha
AU - Anglin, Khamal
AU - Argueta, Urania
AU - Ashktorab, Hassan
AU - Baslet, Gaston
AU - Bassett, Ingrid V.
AU - Bateman, Lucinda
AU - Bedi, Brahmchetna
AU - Bhattacharyya, Shamik
AU - Bind, Marie Abele
AU - Blomkalns, Andra L.
AU - Bonilla, Hector
AU - Bush, Patricia A.
AU - Castro, Mario
AU - Chan, James
AU - Charney, Alexander W.
AU - Chen, Peter
AU - Chibnik, Lori B.
AU - Chu, Helen Y.
AU - Clifton, Rebecca G.
AU - Costantine, Maged M.
AU - Cribbs, Sushma K.
AU - Davila Nieves, Sylvia I.
AU - Deeks, Steven G.
AU - Duven, Alexandria
AU - Emery, Ivette F.
AU - Erdmann, Nathan
AU - Erlandson, Kristine M.
AU - Ernst, Kacey C.
AU - Farah-Abraham, Rachael
AU - Whiteheart, Sidney W.
N1 - Publisher Copyright:
© 2023 American Medical Association. All rights reserved.
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. Objective: To 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. Objective: To 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.
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U2 - 10.1001/jama.2023.8823
DO - 10.1001/jama.2023.8823
M3 - Article
C2 - 37278994
AN - SCOPUS:85161965284
SN - 0098-7484
VL - 329
SP - 1934
EP - 1946
JO - JAMA
JF - JAMA
IS - 22
ER -
