一项队列研究中使用FLU-PRO Plus报告的COVID-19患者症状：与感染基因型、疫苗接种史及康复的关联
COVID-19 Patient-Reported Symptoms Using FLU-PRO Plus in a Cohort Study: Associations With Infecting Genotype, Vaccine History, and Return to Health.
作者信息
Richard Stephanie A, Epsi Nusrat J, Lindholm David A, Malloy Allison M W, Maves Ryan C, Berjohn Catherine M, Lalani Tahaniyat, Smith Alfred G, Mody Rupal M, Ganesan Anuradha, Huprikar Nikhil, Colombo Rhonda E, Colombo Christopher J, Madar Cristian, Jones Milissa U, Larson Derek T, Ewers Evan C, Bazan Samantha, Fries Anthony C, Maldonado Carlos J, Simons Mark P, Rozman Julia S, Andronescu Liana, Mende Katrin, Tribble David R, Agan Brian K, Burgess Timothy H, Pollett Simon D, Powers John H
机构信息
Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
出版信息
Open Forum Infect Dis. 2022 Jun 7;9(7):ofac275. doi: 10.1093/ofid/ofac275. eCollection 2022 Jul.
BACKGROUND
Patient-reported outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are an important measure of the full burden of coronavirus disease (COVID). Here, we examine how (1) infecting genotype and COVID-19 vaccination correlate with inFLUenza Patient-Reported Outcome (FLU-PRO) Plus score, including by symptom domains, and (2) FLU-PRO Plus scores predict return to usual activities and health.
METHODS
The idemiology, mmunology, and linical haracteristics of pandemic infectious diseases (EPICC) study was implemented to describe the short- and long-term consequences of SARS-CoV-2 infection in a longitudinal, observational cohort. Multivariable linear regression models were run with FLU-PRO Plus scores as the outcome variable, and multivariable Cox proportional hazards models evaluated effects of FLU-PRO Plus scores on return to usual health or activities.
RESULTS
Among the 764 participants included in this analysis, 63% were 18-44 years old, 40% were female, and 51% were White. Being fully vaccinated was associated with lower total scores (β = -0.39; 95% CI, -0.57 to -0.21). The Delta variant was associated with higher total scores (β = 0.25; 95% CI, 0.05 to 0.45). Participants with higher FLU-PRO Plus scores were less likely to report returning to usual health and activities (health: hazard ratio [HR], 0.46; 95% CI, 0.37 to 0.57; activities: HR, 0.56; 95% CI, 0.47 to 0.67). Fully vaccinated participants were more likely to report returning to usual activities (HR, 1.24; 95% CI, 1.04 to 1.48).
CONCLUSIONS
Full SARS-CoV-2 vaccination is associated with decreased severity of patient-reported symptoms across multiple domains, which in turn is likely to be associated with earlier return to usual activities. In addition, infection with the Delta variant was associated with higher FLU-PRO Plus scores than previous variants, even after controlling for vaccination status.
背景
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的患者报告结局是衡量冠状病毒病（COVID）全部负担的一项重要指标。在此，我们研究（1）感染基因型和COVID-19疫苗接种如何与流感患者报告结局（FLU-PRO）加分项评分相关，包括按症状领域划分，以及（2）FLU-PRO加分项评分如何预测恢复正常活动和健康状况。
方法
开展大流行传染病的流行病学、免疫学和临床特征（EPICC）研究，以描述纵向观察队列中SARS-CoV-2感染的短期和长期后果。以FLU-PRO加分项评分为结果变量进行多变量线性回归模型分析，多变量Cox比例风险模型评估FLU-PRO加分项评分对恢复正常健康或活动的影响。
结果
在纳入本次分析的764名参与者中，63%为18至44岁，40%为女性，51%为白人。完全接种疫苗与较低的总分相关（β = -0.39；95%置信区间，-0.57至-0.21）。德尔塔变异株与较高的总分相关（β = 0.25；95%置信区间，0.05至0.45）。FLU-PRO加分项评分较高的参与者报告恢复正常健康和活动的可能性较小（健康：风险比[HR]，0.46；95%置信区间，0.37至0.57；活动：HR，0.56；95%置信区间，0.47至0.67）。完全接种疫苗的参与者更有可能报告恢复正常活动（HR，1.24；95%置信区间，1.04至1.48）。
结论
SARS-CoV-2完全接种疫苗与多个领域患者报告症状的严重程度降低相关，这反过来可能与更早恢复正常活动有关。此外，即使在控制了疫苗接种状态后，感染德尔塔变异株与比先前变异株更高的FLU-PRO加分项评分相关。
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