Persistence, Magnitude, and Patterns of Postacute Symptoms and Quality of Life Following Onset of SARS-CoV-2 Infection: Cohort Description and Approaches for Measurement

Abstract

BACKGROUND There is mounting evidence for the presence of post-acute sequelae of SARS-CoV-2 infection (PASC), but there is limited information on the spectrum, magnitude, duration, and patterns of these sequelae as well as their influence on quality of life. METHODS We assembled a cohort of adults with documented history of SARS-CoV-2 RNA-positivity who were ≥ 2 weeks past onset of COVID-19 symptoms or, if asymptomatic, first positive test. At 4-month intervals, we queried physical and mental health symptoms and quality of life. RESULTS Of the first 179 participants enrolled, 10 were asymptomatic during the acute phase of SARS-CoV-2 infection, 125 symptomatic but not hospitalized, and 44 symptomatic and hospitalized. During the post-acute phase, fatigue, shortness of breath, concentration problems, headaches, trouble sleeping and anosmia/dysgeusia were most common through 8 months of observation. Symptoms were typically at least somewhat bothersome and sometimes exhibited a waxing-and-waning course. Some participants experienced symptoms of depression, anxiety, and post-traumatic stress, as well as difficulties with performance of usual activities. The median visual analogue scale rating of general health was lower at 4 and 8 months compared to pre-COVID-19. Two clusters of symptom domains were identified. CONCLUSION Many participants report bothersome symptoms following onset of COVID-19 with variable patterns of persistence and impact on quality of life. The substantial variability suggests the existence of multiple sub-phenotypes of PASC. A rigorous approach to the prospective measurement of symptoms and functional manifestations sets the stage for the next phase of research focusing on the pathophysiologic causes of the various sub-groups of PASC.

Post-Acute Sequelae and Adaptive Immune Responses in People Living With Hiv Recovering From Sars-Cov-2 Infection

“…Our methodology for assessing PASC in the cohort is described in detail elsewhere [20]. Briefly, responses to questions regarding the presence of 32 somatic symptoms derived from the U.S. Centers for Disease Control (CDC) list of COVID-19 symptoms (https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html) and the Patient Health Questionnaire Somatic Symptom Scale [24] were characterized at each study visit.…”

“…Volunteers were enrolled into the Long-term Impact of Infection with Novel Coronavirus (LIINC) COVID-19 recovery cohort at UCSF (NCT 04362150). Study procedures are described in detail elsewhere [41,42]. Briefly, participants with a prior positive nucleic acid amplification test confirming SARS-CoV-2 infection were enrolled >=21 days following symptom onset.…”

“…Our methodology for assessing PASC in the cohort is described in detail elsewhere [42]. At each study visit, we tabulate responses to questions regarding the presence of 32 somatic symptoms derived from the U.S. Centers for Disease Control (CDC) list of COVID-19 symptoms [46] and the Patient Health Questionnaire Somatic Symptom Scale [47].…”

“…Our methodology for assessing PASC in the cohort is described in detail elsewhere [20]. Briefly, responses to questions regarding the presence of 32 somatic symptoms derived from the U.S. For the primary analysis, we defined PASC as any COVID-19 attributed symptom that was present during a study visit >6 weeks following SARS-CoV-2 infection following consensus definitions [25,26].…”

SARS‐CoV‐2 and Mitochondrial Proteins in Neural‐Derived Exosomes of COVID‐19

“…All participants were enrolled in the San Francisco‐based Long‐term Impact of Infection with Novel Coronavirus (LIINC) COVID‐19 recovery cohort (NCT04362150; www.liincstudy.org ) in the period March, 2020 to February, 2021 through physician‐ or self‐referral after a positive test result from a nasal or throat swab sample. 26 , 27 , 28 Their initial evaluation included confirmation of prior SARS‐CoV‐2 RNA positivity, a complete range of basic clinical laboratory studies, and detailed assessment of acute and post‐acute COVID‐19‐attributable symptoms by a clinical research coordinator and infectious disease specialist physician. This interview checklist encompassed questions about current symptoms, preexisting co‐morbidities and disabilities due to the present illness.…”