Post COVID-19 condition of the Omicron variant of SARS-CoV-2

Morioka, Shigefumi; Tsuzuki, Shinya; Suzuki, Michiyo; Terada, Mari; Akashi, Masahiro; Osanai, Yasuyo; Kuge, Chika; Sanada, Mio; Tanaka, Keiko; Maruki, Taketomo; Takahashi, Kozue; Saito, Sho; Hayakawa, Kayoko; Teruya, Katsuji; Hojo, Masayuki; Ohmagari, Norio

doi:10.1016/j.jiac.2022.08.007

Cited by 44 publications

(48 citation statements)

References 15 publications

(28 reference statements)

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“…The frequency of Long COVID after infection with the Omicron variant has been reported to be 5% at ≥4 weeks after infection, which is about half compared to the Delta variant 9 . Comparing people infected with Omicron vs. previous variants, 5 vs. 55% reported ≥1 PASC symptom in another study 28 . However, both studies have not included a non-infected control group, which allows to better interpret the significance of these findings.…”

Section: Discussionmentioning

confidence: 94%

Association of viral variant and vaccination status with the occurrence of symptoms compatible with post-acute sequelae after primary SARS-CoV-2 infection

Kahlert

Strahm

Güsewell

et al. 2022

Preprint

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ImportanceDisentangling the effects of different SARS-CoV-2 variants and of vaccination on the occurrence of post-acute sequelae of SARS-CoV-2 (PASC) is crucial to estimate and potentially reduce the future burden of PASC.ObjectiveTo determine the association of primary SARS-CoV-2 infection on the frequency of PASC symptoms by viral variant and vaccination status.DesignCross-sectional questionnaire and SARS-CoV-2 serology (May/June 2022) performed within a prospective healthcare worker cohort (SURPRISE study).SettingMulticenter study in nine healthcare networks from North-Eastern Switzerland.ParticipantsVolunteer sample of healthcare workers (HCW) from participating institutions. Of approximately 20’000 eligible participants, 3’870 registered for the cohort and 2’912 were included in this analysis.ExposuresSARS-CoV-2 infection documented by positive nasopharyngeal swab (>4 weeks ago), stratified by viral variant and vaccination status at time of infection, compared to absence of documented infection (no positive swab, negative serology).Main OutcomeSum score of eighteen self-reported PASC symptoms.ResultsAmong 2’912 participants (median age 44 years, 81.3% female), SARS-CoV-2 infection was reported by 1’685 (55.9%) participants, thereof 315 (18.7%) during Wild-type, 288 (17.1%) during Alpha/Delta, and 1’082 (64.2%) during Omicron circulation. Mean symptom number in previously infected participants significantly exceeded that of uninfected controls (0.39), but decreased with recency of the viral variant: 1.12 (p<0.001) for Wild-type (median time since infection 18.5 months), 0.67 (p<0.001) for Alpha/Delta (6.6 months), and 0.52 (p=0.005) for Omicron BA.1 (3.1 months) infected participants. After Omicron BA.1 infection, the mean symptom score was 0.49 (p=0.30) for those with ≥3 prior vaccinations and 0.71 (p=0.028) with 1-2 previous vaccinations compared to 0.36 for unvaccinated individuals. Adjusting for confounders, Wild-type (adjusted risk ratio [aRR] 2.81, 95% confidence interval [CI] 2.08-3.83) and Alpha/Delta infection (aRR 1.93, 95% CI 1.10-3.46) showed significant associations with the outcome, whereas Omicron BA.1 infection (aRR 1.29, 95% CI 0.69–2.43) and vaccination before infection (aRR 1.27, 95% CI 0.82–1.94) did not.Conclusions and RelevancePrevious infection with pre-Omicron variants was the strongest risk factor for reporting PASC symptoms in this HCW cohort. A definite influence of prior vaccination on the prevention of PASC after Omicron BA.1 infection was not measurable.

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Section: Discussionmentioning

confidence: 94%

Association of viral variant and vaccination status with the occurrence of symptoms compatible with post-acute sequelae after primary SARS-CoV-2 infection

Kahlert

Strahm

Güsewell

et al. 2022

Preprint

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“…These estimates are in line with a relative risk reduction of 33% between infections with Omicron and prior variants at three months reported in a previous study. 19 While one further study reported no association of pooled Omicron and Delta infection with PCC compared to Wildtype infection at four weeks, 9 another reported a stronger risk reduction between Omicron and Delta infection among vaccinated individuals. 18 They also found a stronger risk reduction among those vaccinated more than three months prior infection compared to those infected less than three months before.…”

Section: Discussionmentioning

confidence: 98%

“…Model selection was based on prior knowledge (a priori variables were age, sex, presence of comorbidities (any of hypertension, diabetes, cardiovascular disease, chronic respiratory disease, malignancy, or immune suppression), and initial hospitalization due to COVID-19) and the Akaike and Bayesian Information Criteria (AIC/BIC; no further variables were added). In sensitivity analyses and to ensure comparability with other studies, 9,19 we used an alternative model specification including SARS-CoV-2 variant, vaccination status, and prior infection as separate variables. We calculated odds ratios (ORs) and associated 95% CIs for all variables of interest.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, the evidence regarding infection with novel SARS-CoV-2 variants remains limited and inconsistent. While there is some evidence that infections with the Omicron variant reduced the risk of developing PCC compared to the Delta 18 or any previous variant 19 , evidence from another study demonstrated a reduced risk with the Alpha variant, but not with the Delta or Omicron variant compared to Wildtype SARS-CoV-2. 9 However, all three studies drew from specific samples not representative of the general population, and none of them has evaluated PCC for more than 12 weeks after infection.…”

Section: Introductionmentioning

confidence: 95%

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Post COVID-19 condition after Wildtype, Delta, and Omicron variant SARS-CoV-2 infection and vaccination: pooled analysis of two population-based cohorts

Menges

Kaufmann

Amati

et al. 2022

Preprint

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Background: Post COVID-19 condition (PCC) is an important complication of SARS-CoV-2 infection, affecting millions worldwide. Further evidence is needed on the risk of PCC after vaccination and infection with newer variants. This study aimed to evaluate the prevalence and severity of PCC across different variants and vaccination histories. Methods: We used pooled data from 1350 SARS-CoV-2-infected individuals from two representative population-based cohorts in Switzerland, diagnosed between Aug 5, 2020, and Feb 25, 2022. We descriptively analysed the prevalence and severity of PCC, defined as the presence and frequency of PCC-related symptoms six months after infection, among vaccinated and non-vaccinated individuals infected with Wildtype, Delta, and Omicron SARS-CoV-2. We used multivariable logistic regression models to assess the association and estimate the risk reduction of PCC after infection with newer variants and prior vaccination. We further assessed associations with the severity of PCC using multinomial logistic regression. To identify groups of individuals with similar symptom patterns and evaluate differences in the presentation of PCC across variants, we performed exploratory hierarchical cluster analyses. Findings: We found strong evidence that vaccinated individuals infected with Omicron had a reduced risk of developing PCC compared to non-vaccinated Wildtype-infected individuals (odds ratio 0.42, 95% confidence interval 0.24-0.68). The risk among non-vaccinated individuals was similar after infection with Delta or Omicron compared to Wildtype SARS-CoV-2. We found no differences in PCC prevalence with respect to the number of received vaccine doses or timing of last vaccination. The prevalence of PCC-related symptoms among vaccinated, Omicron-infected individuals was lower across severity levels. In cluster analyses, we identified four clusters of diverse systemic, neurocognitive, cardiorespiratory, and musculoskeletal symptoms, with similar patterns across variants. Interpretation: The risk of PCC appears to be lowered with infection by the Omicron variant and after prior vaccination. This evidence is crucial to guide future public health measures and vaccination strategies. Study registrations: ISRCTN14990068, ISRCTN18181860

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“…Risk factors identified for PCC include female sex, ethnicity/race, specific comorbidities, greater number of acute COVID-19 symptoms, and severe COVID-19 disease requiring hospitalisation, ICU or invasive mechanical ventilation (5,10,(15)(16)(17)(18). Recent studies have suggested that the prevalence of PCC among people infected during the Omicron-dominant wave was lower than those infected in previous waves dominated by Delta and Alpha (10,(19)(20)(21). Some studies have also suggested that COVID-19 vaccination may reduce the risk of developing PCC (22)(23)(24).…”

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confidence: 99%

A cohort study of Post COVID-19 Condition across the Beta, Delta and Omicron waves in South Africa: 6-month follow up of hospitalised and non-hospitalised participants

Jassat

Mudara

Vika

et al. 2022

Preprint

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Background A third of people may experience persistent symptoms following COVID-19. With over 90% of South Africans having evidence of prior SARS-CoV-2 infection, it is likely that many people could be affected by Post COVID-19 Condition (PCC). Methods This was a prospective, longitudinal observational cohort study recruiting hospitalised and non-hospitalised participants, infected during the periods that Beta, Delta and Omicron BA.1 variants dominated in South Africa. Participants aged 18 years or older were randomly selected to undergo telephone assessment at 1, 3 and 6 months after hospital discharge or laboratory-confirmed SARS-CoV-2 infection. Participants were assessed using a standardised questionnaire for evaluation of symptoms and health-related quality of life. We used negative binomial regression models to determine factors associated with the presence of 1 or more symptoms at 6 months. Findings Among hospitalised and non-hospitalised participants, 46.7% (1,227/2,626) and 18.5% (199/1,074) had 1 or more symptoms at 6 months (p=<0.001). Among hospitalised participants 59.5%, 61.2% and 18.5% experienced symptoms at 6 months among individuals infected during the Beta, Delta and Omicron dominant waves respectively. Among PLWH who were hospitalised, 40.4% had symptoms at 6 months compared to 47.1% among HIV-uninfected participants (p=0.108). Risk factors for PCC included older age, female sex, non-black race, the presence of a comorbidity, greater number of acute COVID-19 symptoms, hospitalisation/ COVID-19 severity and wave period (individuals infected during the Omicron-dominated wave had a lower risk of persistent symptoms [adjusted Incident Risk Ratio 0.45; 95% Confidence Interval 0.36-0.57] compared to those infected during the Beta-dominated wave). There were no associations between self-reported vaccination status before or after SARS-CoV-2 infection with persistent symptoms. Interpretation The study revealed a high prevalence of persistent symptoms among South African participants at 6 months although decreased risk for PCC among participants infected during the Omicron BA.1 wave. These findings have serious implications for countries with resource-constrained healthcare systems. Funding Bill & Melinda Gates Foundation, UK Foreign, Commonwealth & Development Office, and Wellcome.

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Post COVID-19 condition of the Omicron variant of SARS-CoV-2

Cited by 44 publications

References 15 publications

Association of viral variant and vaccination status with the occurrence of symptoms compatible with post-acute sequelae after primary SARS-CoV-2 infection

Association of viral variant and vaccination status with the occurrence of symptoms compatible with post-acute sequelae after primary SARS-CoV-2 infection

Post COVID-19 condition after Wildtype, Delta, and Omicron variant SARS-CoV-2 infection and vaccination: pooled analysis of two population-based cohorts

A cohort study of Post COVID-19 Condition across the Beta, Delta and Omicron waves in South Africa: 6-month follow up of hospitalised and non-hospitalised participants

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