Joseph Gili, Margalit Ili, Weiss-Ottolenghi Yael, Rubin Carmit, Murad Havi, Gardner Raquel C, Barda Noam, Ben-Shachar Elena, Indenbaum Victoria, Gilboa Mayan, Alroy-Preis Sharon, Kreiss Yitshak, Lustig Yaniv, Regev-Yochay Gili
The Sheba Pandemic Preparedness Research Institute (SPRI), Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.
Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.
Viruses. 2024 Dec 20;16(12):1955. doi: 10.3390/v16121955.
BACKGROUND/OBJECTIVES: Millions of individuals worldwide continue to experience symptoms following SARS-CoV-2 infection. This study aimed to assess the prevalence and phenotype of multi-system symptoms attributed to Long COVID-including fatigue, pain, cognitive-emotional disturbances, headache, cardiopulmonary issues, and alterations in taste and smell-that have persisted for at least two years after acute infection, which we define as "persistent Long COVID". Additionally, the study aimed to identify clinical features and blood biomarkers associated with persistent Long COVID symptoms.
We sent a detailed long COVID symptoms questionnaire to an existing cohort of 1258 vaccinated adults (age 18-79 years) who had mild infection (e.g., non-hospitalized) SARS-CoV-2 Delta variant 2 years earlier. These individuals had comprehensive datasets, including blood samples, available for further analysis. We estimated prevalence of persistent long COVID two years post-infection using weighted adjustment (Horvitz-Thompson estimator) to overcome reporting bias. Multivariable logistic regression models were used to determine association of clinical features and blood biomarkers (pre-infection SARS-CoV-2 RBD-IgG, SARS-CoV-2 neutralizing antibodies, and pre-infection and post-infection neurofilament light) with prevalence of persistent long COVID.
N = 323 participants responded to the survey, of whom N = 74 (23%) reported at least one long COVID symptom that had persisted for two years after the acute infection. Weighted prevalence of persistent long COVID symptoms was 21.5% (95% CI = 16.7-26.3%). Female gender, smoking, and severity of acute COVID-19 infection were significantly associated with persistent Long COVID. The blood biomarkers assessed were not significantly associated with persistent Long COVID.
Among vaccinated adults two years after mild infection with Delta variant SARS-CoV-2, persistent symptoms attributed to Long COVID are extremely common, certain subgroups are at higher risk, and further research into biological mechanisms and potential treatment targets is needed.
背景/目的：全球数百万人在感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）后仍持续出现症状。本研究旨在评估归因于长期新冠的多系统症状的患病率和表型，这些症状包括疲劳、疼痛、认知-情绪障碍、头痛、心肺问题以及味觉和嗅觉改变，在急性感染后至少持续了两年，我们将其定义为“持续性长期新冠”。此外，该研究旨在确定与持续性长期新冠症状相关的临床特征和血液生物标志物。
我们向一个现有的队列发送了一份详细的长期新冠症状问卷，该队列由1258名接种过疫苗的成年人（年龄18 - 79岁）组成，他们在两年前感染了症状较轻（如未住院）的SARS-CoV-2德尔塔变种。这些个体拥有包括血液样本在内的综合数据集，可用于进一步分析。我们使用加权调整（霍维茨-汤普森估计量）来克服报告偏倚，估计感染两年后持续性长期新冠的患病率。多变量逻辑回归模型用于确定临床特征和血液生物标志物（感染前SARS-CoV-2受体结合域免疫球蛋白G、SARS-CoV-2中和抗体以及感染前和感染后神经丝轻链）与持续性长期新冠患病率之间的关联。
N = 323名参与者回复了调查，其中N = 74名（23%）报告至少有一种长期新冠症状在急性感染后持续了两年。持续性长期新冠症状的加权患病率为21.5%（95%置信区间 = 16.7 - 26.3%）。女性、吸烟以及急性新冠病毒感染的严重程度与持续性长期新冠显著相关。所评估的血液生物标志物与持续性长期新冠无显著关联。
在轻度感染SARS-CoV-2德尔塔变种两年后的接种疫苗成年人中，归因于长期新冠的持续性症状极为常见，某些亚组风险更高，需要进一步研究其生物学机制和潜在治疗靶点。
