Author:
Saigal Anita,Nagoda Niklewicz Camila,Naidu Sindhu Bhaarrati,Bintalib Heba M,Shah Amar Jitu,Seligmann George,Hunter Alan Stewart,Wey Emmanuel,Abubakar Ibrahim,Mahungu Tabitha,Miller David,Barnett Joseph,Jain Neel Gautam,Brill Simon,Goldring James,Jarvis Hannah,Smith Colette,Ogbonnaya Chibueze,Hurst John R,Lipman Marc C I,Mandal Swapna
Abstract
ObjectivesCOVID-19 studies report on hospital admission outcomes across SARS-CoV-2 waves of infection but knowledge of the impact of SARS-CoV-2 variants on the development of Long COVID in hospital survivors is limited. We sought to investigate Long COVID outcomes, aiming to compare outcomes in adult hospitalised survivors with known variants of concern during our first and second UK COVID-19 waves, prior to widespread vaccination.DesignProspective observational cross-sectional study.SettingSecondary care tertiary hospital in the UK.ParticipantsThis study investigated Long COVID in 673 adults with laboratory-positive SARS-CoV-2 infection or clinically suspected COVID-19, 6 weeks after hospital discharge. We compared adults with wave 1 (wildtype variant, admitted from February to April 2020) and wave 2 patients (confirmed Alpha variant on viral sequencing (B.1.1.7), admitted from December 2020 to February 2021).Outcome measuresAssociations of Long COVID presence (one or more of 14 symptoms) and total number of Long COVID symptoms with SARS-CoV-2 variant were analysed using multiple logistic and Poisson regression, respectively.Results322/400 (wave 1) and 248/273 (wave 2) patients completed follow-up. Predictors of increased total number of Long COVID symptoms included: pre-existing lung disease (adjusted count ratio (aCR)=1.26, 95% CI 1.07, 1.48) and more COVID-19 admission symptoms (aCR=1.07, 95% CI 1.02, 1.12). Weaker associations included increased length of inpatient stay (aCR=1.02, 95% CI 1.00, 1.03) and later review after discharge (aCR=1.00, 95% CI 1.00, 1.01). SARS-CoV-2 variant was not associated with Long COVID presence (OR=0.99, 95% CI 0.24, 4.20) or total number of symptoms (aCR=1.09, 95% CI 0.82, 1.44).ConclusionsPatients with chronic lung disease or greater COVID-19 admission symptoms have higher Long COVID risk. SARS-CoV-2 variant was not predictive of Long COVID though in wave 2 we identified fewer admission symptoms, improved clinical trajectory and outcomes. Addressing modifiable factors such as length of stay and timepoint of clinical review following discharge may enable clinicians to move from Long COVID risk stratification towards improving its outcome.
Subject
Pulmonary and Respiratory Medicine
Reference34 articles.
1. Statista . COVID-19/Coronavirus facts and figures. 2023. Available: https://www.statista.com/page/covid-19-coronavirus [Accessed 05 May 2023].
2. Office for National Statistics . Prevalence of ongoing symptoms following Coronavirus (COVID-19) infection in the UK: 30 March 2023. 2023. Available: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/30march2023 [Accessed 05 May 2023].
3. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19
4. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis
5. NICE guideline [NG188 . COVID-19 rapid guideline: managing the long-term effects of COVID-19. 2022. Available: https://www.nice.org.uk/guidance/NG188 [Accessed 14 Mar 2022].
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献