Post-Acute Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection by Viral Variant and Vaccination Status: A Multicenter Cross-Sectional Study-Reference-Cited by-同舟云学术

Post-Acute Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection by Viral Variant and Vaccination Status: A Multicenter Cross-Sectional Study

Published:2023-03-11 Issue:2 Volume:77 Page:194-202
ISSN:1058-4838
Container-title:Clinical Infectious Diseases
language:en
Short-container-title:

Author:

Kahlert Christian R¹²,Strahm Carol¹,Güsewell Sabine¹,Cusini Alexia³,Brucher Angela⁴,Goppel Stephan⁵,Möller Elisabeth⁶,Möller J Carsten⁷,Ortner Manuela⁸,Ruetti Markus⁹,Stocker Reto¹⁰,Vuichard-Gysin Danielle¹¹¹²,Besold Ulrike¹³,McGeer Allison¹⁴,Risch Lorenz¹⁵¹⁶¹⁷,Friedl Andrée¹⁸,Schlegel Matthias¹,Vernazza Pietro¹,Kuster Stefan P¹,Kohler Philipp¹^ORCID,Besold Ulrike,Brucher Angela,Cusini Alexia,Egger Thomas,Friedl Andrée,Goppel Stephan,Grässli Fabian,Kahlert Christian R,Keller Joelle,Kessler Simone,Kohler Philipp,Kuster Stefan P,Leal Onicio,Lemmenmeier Eva,McGeer Allison,Kleeb Dorette Meier,Möller Elisabeth,Möller J Carsten,Müller Maja F,Musa Vaxhid,Ortner Manuela,Rieder Philip,Risch Lorenz,Ruetti Markus,Schlegel Matthias,Schmid Hans-Ruedi,Stocker Reto,Vernazza Pietro,von Kietzell Matthias,Vuichard-Gysin Danielle,Wiggli Benedikt,

Affiliation:

1. Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen , St. Gallen , Switzerland

2. Department of Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland , St. Gallen , Switzerland

3. Division of Infectious Diseases, Cantonal Hospital of Grisons , Chur , Switzerland

4. Ambulatory Services, Psychiatry Services of the Canton of St. Gallen (South) , St. Gallen , Switzerland

5. Ambulatory Services, Psychiatry Services of the Canton of St. Gallen (North) , St. Gallen , Switzerland

6. Department of Psychiatry, Clienia Littenheid , Littenheid , Switzerland

7. Center for Neurological Rehabilitation , Zihlschlacht , Switzerland

8. Rheintal Werdenberg Sarganserland Hospital Group , Grabs , Switzerland

9. Fuerstenland Toggenburg Hospital Group , Wil , Switzerland

10. Hirslanden Clinic , Zurich , Switzerland

11. Division of Infectious Diseases and Hospital Epidemiology, Thurgau Hospital Group , Muensterlingen , Switzerland

12. Department of Research and Development, Swiss National Centre for Infection Prevention (Swissnoso) , Berne , Switzerland

13. Geriatric Clinic St. Gallen , St. Gallen , Switzerland

14. Sinai Health System , Toronto , Canada

15. Labormedizinisches Zentrum Dr Risch Ostschweiz AG , Buchs , Switzerland

16. Private Universität im Fürstentum Liechtenstein , Triesen , Liechtenstein

17. Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Inselspital , Bern , Switzerland

18. Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Baden , Baden , Switzerland

Abstract

Abstract Background Disentangling the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and vaccination on the occurrence of post-acute sequelae of SARS-CoV-2 (PASC) is crucial to estimate and reduce the burden of PASC. Methods We performed a cross-sectional analysis (May/June 2022) within a prospective multicenter healthcare worker (HCW) cohort in north-eastern Switzerland. HCWs were stratified by viral variant and vaccination status at time of their first positive SARS-CoV-2 nasopharyngeal swab. HCWs without positive swab and with negative serology served as controls. The sum of 18 self-reported PASC symptoms was modeled with univariable and multivariable negative-binomial regression to analyze the association of mean symptom number with viral variant and vaccination status. Results Among 2912 participants (median age: 44 years; 81.3% female), PASC symptoms were significantly more frequent after wild-type infection (estimated mean symptom number: 1.12; P < .001; median time since infection: 18.3 months), after Alpha/Delta infection (0.67 symptoms; P < .001; 6.5 months), and after Omicron BA.1 infections (0.52 symptoms; P = .005; 3.1 months) versus uninfected controls (0.39 symptoms). After Omicron BA.1 infection, the estimated mean symptom number was 0.36 for unvaccinated individuals versus 0.71 with 1–2 vaccinations (P = .028) and 0.49 with ≥3 prior vaccinations (P = .30). Adjusting for confounders, only wild-type (adjusted rate ratio [aRR]: 2.81; 95% confidence interval [CI]: 2.08–3.83) and Alpha/Delta infections (aRR: 1.93; 95% CI: 1.10–3.46) were significantly associated with the outcome. Conclusions Previous infection with pre-Omicron variants was the strongest risk factor for PASC symptoms among our HCWs. Vaccination before Omicron BA.1 infection was not associated with a clear protective effect against PASC symptoms in this population.

Funder

Swiss National Sciences Foundation

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Link

https://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciad143/49780508/ciad143.pdf

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