Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
BMJ Open. 2024 Sep 10;14(9):e087235. doi: 10.1136/bmjopen-2024-087235.
This study aims to describe the incidence, symptom clusters and determinants of post-acute COVID symptoms using data from the COVID RADAR app in the Netherlands.
Prospective cohort.
General population in the Netherlands from April 2020 to February 2022.
A total of 1478 COVID RADAR app users, with data spanning 40 days before to 100 days after positive SARS-CoV-2 test.
Incidence and duration of 10 new symptoms that developed during acute infection, defined as 10 days prior and 10 days after positive test. Clustering of these post-acute COVID symptoms and associations between factors known in the acute phase and 100-day symptom persistence.
The most frequent post-acute symptoms were cough, loss of smell or taste and fatigue. At 100 days postinfection, 86 (8%) participants still experienced symptoms. Three post-acute COVID symptom clusters were identified: non-respiratory (headache and fatigue; 49% of participants with post-acute COVID symptoms); olfactory (15%) and respiratory (8%). Vaccination was associated with a lower risk of post-acute COVID symptoms 100 days after infection, although CIs were wide (OR: 0.5; 95% CI: 0.2 to 1.5), but not with non-respiratory symptoms (OR: 1.0; 95% CI: 0.3 to 4.4). Severe acute disease increased the risk of post-acute COVID symptoms (OR: 1.4; 95% CI: 1.2 to 1.5; per additional acute symptom).
In this cohort of infected community-dwelling app users, 5%-10% experienced post-acute COVID symptoms. The symptoms cluster in several distinct entities, which differ in incidence, patient characteristics and vaccination effects. This suggests multiple mechanisms underlying the development of post-acute COVID symptoms.
本研究旨在使用荷兰 COVID RADAR 应用程序的数据描述急性 COVID 后症状的发生率、症状群和决定因素。
前瞻性队列研究。
荷兰 2020 年 4 月至 2022 年 2 月的一般人群。
共有 1478 名 COVID RADAR 应用程序用户，数据涵盖阳性 SARS-CoV-2 检测前 40 天和后 100 天。
在急性感染期间出现的 10 种新症状的发生率和持续时间，定义为阳性检测前 10 天和后 10 天。这些急性 COVID 后症状的聚类以及急性阶段已知因素与 100 天症状持续存在之间的关联。
最常见的急性后症状是咳嗽、嗅觉或味觉丧失和疲劳。感染后 100 天，86（8%）名参与者仍有症状。确定了三个急性 COVID 后症状群：非呼吸系统（头痛和疲劳；49%有急性 COVID 后症状的参与者）；嗅觉（15%）和呼吸系统（8%）。尽管置信区间较宽（OR：0.5；95%CI：0.2 至 1.5），但接种疫苗与感染后 100 天发生急性 COVID 后症状的风险较低相关，但与非呼吸系统症状无关（OR：1.0；95%CI：0.3 至 4.4）。严重急性疾病增加了急性 COVID 后症状的风险（OR：1.4；95%CI：1.2 至 1.5；每增加一个急性症状）。
在本感染社区居住的应用程序用户队列中，5%-10%经历了急性 COVID 后症状。这些症状群在几个不同的实体中聚类，在发病率、患者特征和疫苗接种效果方面存在差异。这表明急性 COVID 后症状的发生存在多种机制。
