Impact of COVID-19 and effects of booster vaccination with BNT162b2 on six-month long COVID symptoms, quality of life, work productivity and activity impairment during Omicron

Abstract

Background: Longitudinal estimates of long COVID burden during Omicron remain limited. This study characterized long-term impacts of COVID-19 and booster vaccination on symptoms, Health-Related Quality of Life (HRQoL), and Work Productivity Activity Impairment (WPAI). Methods: Outpatients with ≥1 self-reported symptom and positive SARS-CoV-2 test at CVS Health United States test sites were recruited between 01/31-04/30/2022. Symptoms,EQ-5D and WPAI were collected via online surveys until 6 months following infection. Both observed and model-based estimates were analyzed. Effect sizes based on Cohen's d quantified the magnitude of outcome changes over time, within and between vaccination groups. Mixed models for repeated measures were conducted for multivariable analyses, adjusting for covariates. Logistic regression assessed odds ratio (OR) of long COVID between vaccination groups. Results: At long COVID start (Week 4), 328 participants included 87 (27%) Boosted with BNT162b2, 86 (26%) with a BNT162b2 primary series (Primed), and 155 (47%) Unvaccinated. Mean age was 42.0 years, 73.8% were female, 26.5% had ≥1 comorbidity, 36.9% prior infection, and 39.6% reported ≥3 symptoms (mean: 3.1 symptoms). At Month 6, among 260 participants, Boosted reported a mean of 1.1 symptoms versus 3.4 and 2.8 in Unvaccinated and Primed, respectively (p<0.001). Boosted had reduced risks of ≥3 symptoms versus Unvaccinated (observed: OR 0.22, 95% CI, 0.10-0.47, p<0.001; model-based: OR: 0.36, 95% CI, 0.15-0.87, p=0.019) and Primed (observed: OR 0.29, 95% CI, 0.13-0.67, p=0.003; model-based: OR 0.59, 95% CI, 0.21-1.65, p=0.459). Results were consistent using ≥2 symptoms. Regarding HRQoL, among those with long COVID, Boosted had higher EQ-5D Utility Index (UI) than Unvaccinated (observed: 0.922 versus 0.731, p=0.014; model-based: 0.910 versus 0.758, p-value=0.038) and Primed (0.922 versus 0.648, p=0.014; model-based: 0.910 versus 0.708, p-value=0.008). Observed and model-based estimates for EQ-VAS and UI among Boosted were comparable with pre-COVID since Month 3. Subjects vaccinated generally reported better WPAI scores Conclusions: Long COVID negatively impacted HRQoL and WPAI. The BNT162b2 booster could have a beneficial effect in reducing the risk and burden of long COVID. Boosted participants reported fewer and less durable symptoms, which contributed to improve HRQoL and maintain WPAI levels. Limitations included self-reported data and small sample size for WPAI.

Postacute Sequelae SARS-CoV-2 Infection by Vaccination Status: A Six-Month Latent Class Analysis

“…This analysis supports earlier work that found that the BNT162b2 booster could reduce the risk and burden of PASC (Di Fusco et al 2023). Boosted participants reported fewer and less durable symptoms and vaccination was associated with lower latent symptom burden class, increased quality of life, and decreased activity impairment (Di Fusco et al 2023).…”

“…This finding is relevant to the question of how long SARS-CoV-2 vaccines may be protective (Tenforde, Link-Gelles, and Patel 2022), considering the subjects’ most recent vaccination may be months old prior to enrollment in our study. As previously reported, individuals in the primary vaccine group were vaccinated up to 11 months before the study (Di Fusco et al 2023). In the more recently available booster group, some were boosted up to 4 months before the study (Di Fusco et al 2023).…”

“…As previously reported, individuals in the primary vaccine group were vaccinated up to 11 months before the study (Di Fusco et al 2023). In the more recently available booster group, some were boosted up to 4 months before the study (Di Fusco et al 2023). Reducing the number of SARS-COV-2 symptoms is associated with reduced risk of PASC (Gao, Liu, and Liu 2022).…”

“…The list of symptoms reflected the CDC’s definition of PASC at that time (Centers for Disease Control and Prevention 2022). Presence of symptoms was reported using a checklist-style survey previously described (Di Fusco et al 2023).…”