Kantele Anu, Paajanen Juuso, Pietilä Jukka-Pekka, Vapalahti Olli, Pakkanen Sari H, Lääveri Tinja
Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Biomedicum 1, Haartmaninkatu 8, Helsinki University Hospital and University of Helsinki, 00290, Helsinki, Finland.
Department of Infectious Diseases, Helsinki University Hospital, Helsinki, Finland.
New Microbes New Infect. 2023 Dec 7;56:101209. doi: 10.1016/j.nmni.2023.101209. eCollection 2024 Jan.
Research into persistent symptoms among SARS-CoV-2-positive i.e. CoV(+) patients mostly focuses on hospitalized individuals. Our prospective follow-up study compares long COVID-associated symptoms among laboratory-confirmed CoV(+) and SARS-CoV-2 negative [CoV(-)] individuals.
SARS-CoV-2 RT-PCR-tested volunteers were recruited into four cohorts: 1) CoV(+) outpatients, 2) CoV(-) outpatients, 3) CoV(+) intensive care unit (ICU) inpatients, and 4) CoV(+) non-ICU inpatients. Neutralizing antibodies were assessed and questionnaires filled in at enrolment and days 90-120, 121-180, 181-270, 271-365, and 365-533.
Of the 1326 participants, 1191 were CoV(+): 46 ICU, 123 non-ICU, and 1022 outpatients; 135 were CoV(-) outpatient controls. Both CoV(+) outpatients and CoV(-) controls showed high overall symptom rates at all time points. More prevalent among CoV(+) than CoV(-) outpatients were only impaired olfaction and taste; many others proved more frequent for CoV(-) participants. At ≥181 days, fatigue, dyspnoea, various neuropsychological symptoms and several others were recorded more often for CoV(+) inpatients than outpatients.
Long COVID-associated symptoms were more frequent among hospitalized than non-hospitalized CoV(+) participants. As for outpatients, only impaired olfaction and taste showed higher rates in the CoV(+) group; some symptoms proved even more common among those CoV(-). Besides suggesting low long COVID prevalences for outpatients, our results highlight the weight of negative controls.
对新冠病毒阳性（即CoV(+)）患者持续症状的研究大多集中在住院患者身上。我们的前瞻性随访研究比较了实验室确诊的CoV(+)和新冠病毒阴性（CoV(-)）个体中与新冠长期症状相关的症状。
招募接受新冠病毒逆转录聚合酶链反应（RT-PCR）检测的志愿者进入四个队列：1）CoV(+)门诊患者，2）CoV(-)门诊患者，3）CoV(+)重症监护病房（ICU）住院患者，4）CoV(+)非ICU住院患者。在入组时以及第90 - 120天、121 - 180天、181 - 270天、271 - 365天和365 - 533天评估中和抗体并填写问卷。
1326名参与者中，1191名是CoV(+)：46名ICU患者，123名非ICU患者，1022名门诊患者；135名是CoV(-)门诊对照。CoV(+)门诊患者和CoV(-)对照在所有时间点的总体症状发生率都很高。CoV(+)门诊患者中比CoV(-)门诊患者更普遍的只有嗅觉和味觉受损；其他许多症状在CoV(-)参与者中更常见。在≥181天时，CoV(+)住院患者比门诊患者更频繁地出现疲劳、呼吸困难、各种神经心理症状和其他几种症状。
与新冠长期症状相关的症状在住院的CoV(+)参与者中比未住院的更频繁。对于门诊患者，只有嗅觉和味觉受损在CoV(+)组中的发生率更高；一些症状在CoV(-)患者中甚至更常见。除了表明门诊患者中新冠长期症状的发生率较低外，我们的结果还突出了阴性对照的重要性。
