COVID-19 Patient-Reported Symptoms Using FLU-PRO Plus in a Cohort Study: Associations With Infecting Genotype, Vaccine History, and Return to Health
Author:
Richard Stephanie A12ORCID, Epsi Nusrat J12, Lindholm David A34, Malloy Allison M W4, Maves Ryan C15, Berjohn Catherine M45, Lalani Tahaniyat126ORCID, Smith Alfred G6, Mody Rupal M7, Ganesan Anuradha128, Huprikar Nikhil48, Colombo Rhonda E129, Colombo Christopher J49ORCID, Madar Cristian10, Jones Milissa U410, Larson Derek T511, Ewers Evan C11, Bazan Samantha12, Fries Anthony C13, Maldonado Carlos J14, Simons Mark P1, Rozman Julia S12, Andronescu Liana12, Mende Katrin123, Tribble David R1, Agan Brian K12ORCID, Burgess Timothy H1, Pollett Simon D12, Powers John H15, Cowden J, Darling M, DeLeon S, Lindholm D, Markelz A, Mende K, Merritt S, Merritt T, Turner N, Wellington T, Carl R, Bazan S, Love P K, Dimascio-Johnson N, Ewers E, Gallagher K, Larson D, Rutt A, Blair P, Chenoweth J, Clark D, Chambers S, Colombo C, Colombo R, Conlon C, Everson K, Faestel P, Ferguson T, Gordon L, Grogan S, Lis S, Mount C, Musfeldt D, Odineal D, Perreault M, Robb-McGrath W, Sainato R, Schofield C, Skinner C, Stein M, Switzer M, Timlin M, Wood S, Banks S, Carpenter R, Kim L, Kronmann K, Lalani T, Lee T, Smith A, Smith R, Tant R, Warkentien T, Berjohn C, Cammarata S, Kirkland N, Libraty D, Maves R, Utz G, Chi S, Flanagan R, Jones M, Lucas C, Madar C, Miyasato K, Uyehara C, Agan B, Andronescu L, Austin A, Broder C, Burgess T, Byrne C, Chung K, Davies J, English C, Epsi N, Fox C, Fritschlanski M, Hadley A, Hickey P, Laing E, Lanteri C, Livezey J, Malloy A, Mohammed R, Morales C, Nwachukwu P, Olsen C, Parmelee E, Pollett S, Richard S, Rozman J, Rusiecki J, Samuels E, Sanchez M, Scher A, Simons M, Snow A, Telu K, Tribble D, Tso M, Ulomi L, Wayman M, Merritt T, Wellington T, Clark D, Chambers S, Faestel P, Mount C, Musfeldt D, Schofield C, Kirkland N, Madar C, Uyehara C, Broder C, Byrne C, Chung K, English C, Hickey P, Laing E, Lanteri C, Livezey J, Nwachukwu P, Parmelee E, Samuels E, Sanchez M, Scher A, Tso M, Wayman M, Chao T, Lanter K, Meyer J, Reynolds K, Starr C, Iskander J, Kamara I, Hostler D, Lago K,
Affiliation:
1. Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland , USA 2. The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. , Bethesda, Maryland , USA 3. Brooke Army Medical Center , Fort Sam Houston, Texas , USA 4. Uniformed Services University of the Health Sciences , Bethesda, Maryland , USA 5. Naval Medical Center San Diego , San Diego, California , USA 6. Naval Medical Center Portsmouth , Portsmouth, Virginia , USA 7. William Beaumont Army Medical Center , El Paso, Texas , USA 8. Walter Reed National Military Medical Center , Bethesda, Maryland , USA 9. Madigan Army Medical Center , Joint Base Lewis McChord, Washington , USA 10. Tripler Army Medical Center , Honolulu, Hawaii , USA 11. Fort Belvoir Community Hospital , Fort Belvoir, Virginia , USA 12. Carl R. Darnall Army Medical Center , Fort Hood, Texas , USA 13. US Air Force School of Aerospace Medicine , Dayton, Ohio , USA 14. Womack Army Medical Center , Fort Bragg, North Carolina , USA 15. Clinical Research Directorate, Frederick National Laboratory for Cancer Research , Frederick, Maryland , USA
Abstract
Abstract
Background
Patient-reported outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are an important measure of the full burden of coronavirus disease (COVID). Here, we examine how (1) infecting genotype and COVID-19 vaccination correlate with inFLUenza Patient-Reported Outcome (FLU-PRO) Plus score, including by symptom domains, and (2) FLU-PRO Plus scores predict return to usual activities and health.
Methods
The epidemiology, immunology, and clinical characteristics of pandemic infectious diseases (EPICC) study was implemented to describe the short- and long-term consequences of SARS-CoV-2 infection in a longitudinal, observational cohort. Multivariable linear regression models were run with FLU-PRO Plus scores as the outcome variable, and multivariable Cox proportional hazards models evaluated effects of FLU-PRO Plus scores on return to usual health or activities.
Results
Among the 764 participants included in this analysis, 63% were 18–44 years old, 40% were female, and 51% were White. Being fully vaccinated was associated with lower total scores (β = −0.39; 95% CI, −0.57 to −0.21). The Delta variant was associated with higher total scores (β = 0.25; 95% CI, 0.05 to 0.45). Participants with higher FLU-PRO Plus scores were less likely to report returning to usual health and activities (health: hazard ratio [HR], 0.46; 95% CI, 0.37 to 0.57; activities: HR, 0.56; 95% CI, 0.47 to 0.67). Fully vaccinated participants were more likely to report returning to usual activities (HR, 1.24; 95% CI, 1.04 to 1.48).
Conclusions
Full SARS-CoV-2 vaccination is associated with decreased severity of patient-reported symptoms across multiple domains, which in turn is likely to be associated with earlier return to usual activities. In addition, infection with the Delta variant was associated with higher FLU-PRO Plus scores than previous variants, even after controlling for vaccination status.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Cited by
4 articles.
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