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Post-COVID condition varies by variant and vaccination status

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Post-COVID condition varies by variant and vaccination status

The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus accountable for the coronavirus disease 2019 (COVID-19), led to an awesome strain on public health systems struggling to cope with the influx of cases to stop viral transmission. As COVID-19 survivors gained immunity against SARS-CoV-2, thereby slowing the speed of transmission and reducing the general severity of infection, post-COVID symptoms began to be recognized as evidence of persistent and sometimes disabling disease.

A brand new study published in The Lancet compares post-COVID manifestations brought on by the SARS-CoV-2 wild-type, Alpha, and Delta variants amongst unvaccinated and vaccinated populations.

Study: Profiling post-COVID-19 condition across different variants of SARS-CoV-2: a prospective longitudinal study in unvaccinated wild-type, unvaccinated alpha-variant, and vaccinated delta-variant populations. Image Credit: Starshaker / Shutterstock.com

Introduction

Long COVID is defined as symptoms lasting 28 days or more from the initial positive COVID-19 test. All symptoms persisting for 84 days or more from the primary positive test are considered post-COVID.

Quite a few studies have been conducted on long COVID symptoms because of this of their common occurrence and potential public health burden. The issue of recognizing symptoms as as a consequence of COVID-19 is compounded by the heterogeneous nature of the condition.

By June 2022, about two million people were estimated to have long COVID in the UK. About two-thirds of those individuals reported that their symptoms adversely affected their quality of life.

The present study used data from adults within the U.K. who reported symptoms using the COVID Symptom Study smartphone app from March 24, 2020, and December 8, 2021. All participants were physically healthy for at the least one month before testing positive for COVID-19 after which reported long =COVID symptoms.

The researchers classified the participants by vaccination status and variant of infection. A prospective longitudinal design was used to discover any distinct patterns and disease profiles brought on by different viral variants and vaccination status.

What did the study show?

The study included almost 10,000 individuals with long Covid. Of those, roughly 15% developed post-COVID symptoms. Importantly, neither a lower prevalence nor duration of post-COVID symptoms was observed between vaccinated and unvaccinated individuals.

For the unvaccinated wild-type population, 4 varieties of post-COVID conditions were observed. Comparatively, seven and five conditions were observed within the Alpha unvaccinated population and the vaccinated Delta cohort, respectively.

No matter variant, long COVID symptoms might be classified into three different clusters. These comprised symptoms regarding cardiorespiratory organs, the central nervous system (CNS), and a multi-organ systemic inflammatory condition.

Cardiorespiratory symptoms were typically related to severe breathlessness, particularly with the Alpha or Delta variants. CNS symptoms included loss or reduction of smell, brain fog, headache, and depression. These symptoms weren’t typically related to other symptoms when brought on by the Alpha or Delta variants.

While gut symptoms were reported, they occurred in two or less phenotypes for every variant.

Wildtype post-COVID

Within the unvaccinated wild-type population, most people presented with cardiorespiratory and CNS symptoms, followed by a cluster with symptoms regarding all phenotypes. Notably, probably the most severe symptoms occurred on this patient population.

The third cluster suffered mainly upper respiratory symptoms, including hoarseness and anosmia, with lack of appetite. The last cluster also had experienced CNS, upper respiratory, and gastrointestinal (GI) symptoms.

The second and fourth clusters had probably the most severe and chronic symptoms. Nonetheless, they didn’t significantly differ from the others when it comes to age, sex, or body mass index.

Alpha post-COVID

Within the unvaccinated alpha population, the most important cluster of patients had CNS symptoms, whereas the smallest cluster of 13 individuals had widely various symptoms.

Delta post-COVID

Post-COVID after Delta infection was primarily related to CNS symptoms in the most important cluster. The smallest cluster also experienced probably the most severe cardiorespiratory symptoms and a few systemic and GI symptoms.

The wild-type second cluster was 75% more likely than all other clusters to seek the advice of a medical skilled to assist with their chronic symptoms. Nonetheless, the third cluster was more prone to seek help for the post-COVID condition.

The second and fourth clusters were 20-30% more prone to report that the condition severely affected their every day life. Women were more in danger for severe impairment in every day life as a consequence of post-COVID and more prone to seek medical help.

What are the implications?

The present study demonstrated the worth of digital apps in tracing and characterizing a large-scale pandemic. The researchers attempted a novel approach to symptom profiling, the outcomes of which yielded three symptom clusters across variants.

These findings corroborate earlier studies reporting differing degrees of functional impairment across people in the final population post-COVID. The identical symptom clusters have been reported in post-COVID evaluation in a COVID-hospitalized cohort.

CNS symptoms are often reported amongst long COVID patients and have been correlated with certain brain imaging phenotypes. Notably, SARS-CoV-2 appears to spread through degenerating olfactory neurons, thereby explaining the prominence of smell-related symptoms.

Cardiorespiratory symptoms are sometimes related to lung damage. Thus, this cluster of long COVID patients ought to be closely monitored for the event of lung lesions.

The present study is the primary to profile post-COVID-19 condition across different SARS-CoV-2 variants and in patients with various vaccination status.”

Importantly, the study findings may be generalized, as this study was conducted in a big sample covering a large spectrum of post-COVID symptoms.

Nevertheless, further studies that include a more representative range of the U.K. population are needed. Vaccination status also needs to be analyzed with greater granularity to raised understand how different SARS-CoV-2 variants affect the danger of developing long COVID.

Our study suggests that future investigations into mechanisms underlying post-COVID-19 condition should consider dividing affected individuals into different subgroups, to discover distinct [underlying] processes.”

Journal reference:

  • Canas, L. S., Molteni, E., Deng, J., et al. (2023). Profiling post-COVID-19 condition across different variants of SARS-CoV-2: a prospective longitudinal study in unvaccinated wild-type, unvaccinated alpha-variant, and vaccinated delta-variant populations. The Lancet. doi:10.1016/S2589-7500(23)00056-0.

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