Inflammatory Markers, Pulmonary Function, and Clinical Symptoms in Acute COVID-19 Among Non-Hospitalized Adolescents and Young Adults

Berven, Lise; Selvakumar, Joel; Havdal, Lise Beier; Stiansen-Sonerud, Tonje; Einvik, Gunnar; Leegaard, Truls Michael; Tjade, Trygve; Michelsen, Annika E.; Mollnes, Tom Eirik; Wyller, Vegard Bruun

doi:10.3389/fimmu.2022.837288

Cited by 16 publications

(23 citation statements)

References 52 publications

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“…A missing link between self-reported symptoms and biological abnormalities has also recently been reported in a patient group with acute SARS-CoV-2 infection. In an observational cohort study of non-hospitalized adolescents and young adults involving n = 405 positive COVID-19 cases and n = 111 non-COVID-19 controls, Lund Berven et al ( 2022 ) found a higher incidence of COVID-typical clinical symptoms among the COVID-19 cases. However, clinical symptoms were independent of objective inflammatory and pulmonary function markers.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic

et al. 2022

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IntroductionLittle is known about risk factors for both Long COVID and somatic symptoms that develop in individuals without a history of COVID-19 in response to the pandemic. There is reason to assume an interplay between pathophysiological mechanisms and psychosocial factors in the etiology of symptom persistence.ObjectiveTherefore, this study investigates specific risk factors for somatic symptom deterioration in a cohort of German adults with and without prior SARS-CoV-2 infection.MethodsGerman healthcare professionals underwent SARS-CoV-2 IgG antibody testing and completed self-rating questionnaires at baseline and 21 months later between April 2020 and February 2022. Differences in variables between the time points were analyzed and a regression analysis was performed to predict somatic symptom deterioration at follow-up.ResultsSeven hundred fifty-one adults completed both assessments. Until follow-up, n = 58 had contracted SARS-CoV-2 confirmed by serology. Between baseline and follow-up, signs of mental and physical strain increased significantly in the sample. Symptom expectations associated with COVID-19 and a self-reported history of COVID-19, but not serologically confirmed SARS-CoV-2 infection, significantly predicted somatic symptom deterioration at follow-up. A further predictor was baseline psychological symptom burden.ConclusionsThis study supports a disease-overarching biopsychosocial model for the development of burdensome somatic symptoms during the COVID-19 pandemic and supports research findings that symptom burden may be more related to the psychosocial effects of the pandemic than to infection itself. Future studies on Long COVID should include SARS-CoV-2 negative control groups and consider symptom burden prior to infection in order to avoid an overestimation of prevalence rates.

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Section: Discussionmentioning

confidence: 99%

Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic

et al. 2022

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“…The long-term effects of COVID-19 in Adolescents (LoTECA) project is a longitudinal observational cohort study of SARS-CoV-2 positive and negative non-hospitalized adolescents and young adults, with a total follow-up time of 12 months (Clinical Trials ID: NCT04686734). Details of the design are reported elsewhere ( 36 ). In this study, results from the baseline visit are reported.…”

Section: Methodsmentioning

confidence: 99%

“…The investigational program included clinical examination, blood sampling, spirometry, 3-lead ECG monitoring for 5 min at rest, cognitive testing, and questionnaire charting ( 36 ). Approximately halfway through the inclusion period, a neurological examination was included in the clinical examination.…”

Section: Methodsmentioning

confidence: 99%

Neurological Involvement in COVID-19 Among Non-Hospitalized Adolescents and Young Adults

et al. 2022

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IntroductionCoronavirus disease 2019 (COVID-19) is prevalent among young people, and neurological involvement has been reported. We investigated neurological symptoms, cognitive test results, and biomarkers of brain injury, as well as associations between these variables in non-hospitalized adolescents and young adults with COVID-19.MethodsThis study reports baseline findings from an ongoing observational cohort study of COVID-19 cases and non-COVID controls aged 12–25 years (Clinical Trials ID: NCT04686734). Symptoms were charted using a standardized questionnaire. Cognitive performance was evaluated by applying tests of working memory, verbal learning, delayed recall, and recognition. The brain injury biomarkers, neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAp), were assayed in serum samples using ultrasensitive immunoassays.ResultsA total of 405 COVID-19 cases and 111 non-COVID cases were prospectively included. Serum Nfl and GFAp concentrations were significantly elevated in COVID-19 cases as compared with non-COVID controls (p = 0.050 and p = 0.014, respectively). The COVID-19 cases reported more fatigue (p < 0.001) and post-exertional malaise (PEM) (p = 0.001) compared to non-COVID-19 controls. Cognitive test performance and clinical neurological examination did not differ across the two groups. Within the COVID-19 group, there were no associations between symptoms, cognitive test results, and NfL or GFAp levels. However, fatigue and PEM were strongly associated with older age and female sex.ConclusionsNon-hospitalized adolescents and young adults with COVID-19 reported more fatigue and PEM and had slightly elevated levels of brain injury markers, but showed normal cognitive performance. No associations were found between symptoms, brain injury markers, and cognitive test results, but fatigue and PEM were strongly related to female sex and older age.

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“…1; Supplementary paragraph 1.1). The six months follow-up data are the main focus of the present paper; selected baseline data have been reported elsewhere 34 . The project was approved by the…”

Section: Methodsmentioning

confidence: 99%

Prevalence and predictors of long COVID among non-hospitalised adolescents and young adults: a prospective controlled cohort study

Wyller

Selvakumar

Havdal

et al. 2022

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The prevalence and predictors of long COVID in young people remain unresolved. We aimed to determine the point prevalence of long COVID in non-hospitalised adolescents and young adults six months after the acute infection, to determine the risk of developing long COVID adjusted for possible confounders, and to explore a broad range of potential risk factors (prespecified outcomes). We conducted a prospective controlled cohort study of 404 SARS-CoV-2-positive and 105 SARS-CoV-2-negative non-hospitalised individuals aged 12–25 years (ClinicalTrial ID: NCT04686734). Data acquisition was completed February 2022. Assessments included pulmonary, cardiac and cognitive functional testing, biomarker analyses, and completion of a questionnaire, and were performed at inclusion (early convalescent stage) and six months follow-up. The WHO case definition of long COVID was applied. The point prevalence of long COVID at six months was 49% and 47% in the SARS-CoV-2-positive and negative group, respectively. SARS-CoV-2-positivity did not predict development of long COVID (relative risk 1.06, 95% CI 0.83 to 1.37). The main predictor was symptom severity at inclusion, which correlated strongly to personality traits. Low physical activity and loneliness were also predictive, while biological markers were not. In conlusion, our study aims were met, and the findings suggest that persistent symptoms were not driven by the infection, but were associated with psychosocial factors.

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Inflammatory Markers, Pulmonary Function, and Clinical Symptoms in Acute COVID-19 Among Non-Hospitalized Adolescents and Young Adults

Cited by 16 publications

References 52 publications

Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic

Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic

Neurological Involvement in COVID-19 Among Non-Hospitalized Adolescents and Young Adults

Prevalence and predictors of long COVID among non-hospitalised adolescents and young adults: a prospective controlled cohort study

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