Rapid implementation of a cohort for the study of post-acute sequelae of SARS-CoV-2 infection/COVID-19
Author:
Peluso Michael J.ORCID, Kelly J. Daniel, Lu Scott, Goldberg Sarah A., Davidson Michelle C., Mathur Sujata, Durstenfeld Matthew S., Spinelli Matthew A., Hoh Rebecca, Tai Viva, Fehrman Emily A., Torres Leonel, Hernandez Yanel, Williams Meghann C., Arreguin Mireya I., Bautista Jennifer A., Ngo Lynn H., Deswal Monika, Munter Sadie E., Martinez Enrique O., Anglin Khamal A., Romero Mariela D., Tavs Jacqueline, Rugart Paulina R., Chen Jessica Y., Sans Hannah M., Murray Victoria W., Ellis Payton K., Donohue Kevin C., Massachi Jonathan A., Weiss Jacob O., Mehdi Irum, Pineda-Ramirez Jesus, Tang Alex F., Wenger Megan, Assenzio Melissa, Yuan Yan, Krone Melissa, Rutishauser Rachel L., Rodriguez-Barraquer Isabel, Greenhouse Bryan, Sauceda John A., Gandhi Monica, Hsue Priscilla Y., Henrich Timothy J., Deeks Steven G.ORCID, Martin Jeffrey N.
Abstract
ABSTRACTBACKGROUNDAs the coronavirus disease 2019 (COVID-19) pandemic continues and millions remain vulnerable to infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), attention has turned to characterizing post-acute sequelae of SARS-CoV-2 infection (PASC).METHODSFrom April 21 to December 31, 2020, we assembled a cohort of consecutive volunteers who a) had documented history of SARS-CoV-2 RNA-positivity; b) were ≥ 2 weeks past onset of COVID-19 symptoms or, if asymptomatic, first test for SARS-CoV-2; and c) were able to travel to our site in San Francisco. Participants learned about the study by being identified on medical center-based registries and being notified or by responding to advertisements. At 4-month intervals, we asked participants about physical symptoms that were new or worse compared to the period prior to COVID-19, mental health symptoms and quality of life. We described 4 time periods: 1) acute illness (0-3 weeks), 2) early recovery (3-10 weeks), 3) late recovery 1 (12-20 weeks), and 4) late recovery 2 (28-36 weeks). Blood and oral specimens were collected at each visit.RESULTSWe have, to date, enrolled 179 adults. During acute SARS-CoV-2 infection, 10 had been asymptomatic, 125 symptomatic but not hospitalized, and 44 symptomatic and hospitalized. In the acute phase, the most common symptoms were fatigue, fever, myalgia, cough and anosmia/dysgeusia. During the post-acute phase, fatigue, shortness of breath, concentration problems, headaches, trouble sleeping and anosmia/dysgeusia were the most commonly reported symptoms, but a variety of others were endorsed by at least some participants. Some experienced symptoms of depression, anxiety, and post-traumatic stress, as well as difficulties with ambulation and performance of usual activities. The median visual analogue scale value rating of general health was lower at 4 and 8 months (80, interquartile range [IQR]: 70-90; and 80, IQR 75-90) compared to prior to COVID-19 (85; IQR 75-90). Biospecimens were collected at nearly 600 participant-visits.CONCLUSIONAmong a cohort of participants enrolled in the post-acute phase of SARS-CoV-2 infection, we found many with persistent physical symptoms through 8 months following onset of COVID-19 with an impact on self-rated overall health. The presence of participants with and without symptoms and ample biological specimens will facilitate study of PASC pathogenesis. Similar evaluations in a population-representative sample will be needed to estimate the population-level prevalence of PASC.
Publisher
Cold Spring Harbor Laboratory
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