Saloma Cynthia P, Ayes Marc Edsel C, Taracatac Paolo S, Asa Meryl Rose Q
Philippine Genome Center, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines.
National Institute of Molecular Biology and Biotechnology, College of Science, University of the Philippines Diliman, Quezon City, Metro Manila, Philippines.
Front Med (Lausanne). 2024 Oct 2;11:1455729. doi: 10.3389/fmed.2024.1455729. eCollection 2024.
Millions have been infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) since its emergence in 2019, but most patients make a full recovery. The long-term consequences of the infection are anticipated to unravel in the succeeding years with reports of patients experiencing chronic, debilitating sequelae post-infection commonly referred to as Long COVID. Various Variants of Concern (VoCs) have emerged as the SARS-CoV-2 virus evolved displaying increased infectivity and immune evasiveness. We investigate whether the infecting VoCs affect the sequelae of Long COVID in a Philippine cohort.
SARS-CoV-2 cases confirmed using RT-PCR followed by Next Generation Sequencing were identified from selected regions of the Philippines and recruited through a retrospective-prospective cohort design. Participants were divided based on the initial infecting VoC or Variant of Interest (VoI) and were subsequently interviewed regarding the presence, intensity, and frequency of key Long COVID symptoms, and followed up on two more separate sessions at least three (3) months apart for a total of three (3) data collection points (S1, S2, S3) to document changes in symptoms throughout the year-long study period.
Long COVID symptoms were reported in 88, 82, and 68% of participants in S1, S2, and S3, respectively, showing declining incidence with elapsed time since the first reported infection. General symptoms including headache, fatigue, and post-exertional malaise were the most frequently reported symptoms, while neuropsychiatric symptoms were the second most frequently reported symptoms. In all three (3) sessions, intermittent brain fog, fatigue, and headache were the most frequently reported symptoms in all SARS-CoV-2 variant cohorts. Factors such as age, sex, comorbidities, and disease severity influenced symptom frequency, providing insight into the risk factors that contribute to the prevalence of this disease.
A large proportion (>68%) of cases in this Philippine cohort previously infected with different SARS-CoV-2 variants presented with long-term complications of COVID-19 characterized by a highly heterogeneous set of debilitating symptoms. The study highlights the need for long-term monitoring of Long COVID and its impact on human health and the need for our health systems to adopt policy response strategies.
自2019年严重急性呼吸综合征冠状病毒2（SARS-CoV-2）出现以来，已有数百万人感染，但大多数患者已完全康复。随着有报告称患者在感染后出现慢性、使人衰弱的后遗症，通常称为“长新冠”，预计在接下来的几年中会逐渐揭示出感染的长期后果。随着SARS-CoV-2病毒的进化，出现了各种值得关注的变异株（VoC），其传染性和免疫逃逸能力增强。我们调查了感染的VoC是否会影响菲律宾队列中“长新冠”的后遗症。
从菲律宾选定地区识别出通过逆转录聚合酶链反应（RT-PCR）确诊并随后进行下一代测序的SARS-CoV-2病例，并通过回顾性-前瞻性队列设计进行招募。参与者根据最初感染的VoC或感兴趣的变异株（VoI）进行分组，随后就关键的“长新冠”症状的存在、强度和频率进行访谈，并在至少相隔三个月的另外两个单独时间段进行随访，总共三个（3）数据收集点（S1、S2、S3），以记录在为期一年的研究期间症状的变化。
在S1、S2和S3中，分别有88%、82%和68%的参与者报告有“长新冠”症状，随着自首次报告感染以来时间的推移，发病率呈下降趋势。包括头痛、疲劳和运动后不适在内的一般症状是最常报告的症状，而神经精神症状是第二常报告的症状。在所有三个（3）时间段中，间歇性脑雾、疲劳和头痛是所有SARS-CoV-2变异株队列中最常报告的症状。年龄、性别、合并症和疾病严重程度等因素影响症状频率，为导致该疾病流行的风险因素提供了见解。
在这个菲律宾队列中，很大一部分（>68%）先前感染不同SARS-CoV-2变异株的病例出现了以一系列高度异质性的使人衰弱症状为特征的新冠长期并发症。该研究强调了对“长新冠”及其对人类健康的影响进行长期监测的必要性，以及我们的卫生系统采取政策应对策略的必要性。
