Association between BNT162b2 vaccination and health-related quality of life up to 18 months post-SARS-CoV-2 infection in Israel: A cross sectional survey (preprint)

We determined whether COVID-19 vaccination was associated with Quality of Life (QoL) changes among individuals previously infected with SARS-CoV-2 in Israel. Using a validated questionnaire, we collected information about socio-demographics, SARS-CoV-2 infection, COVID-19 vaccination and QoL (using the EQ-5D-5L tool) 3–18 months post-infection among adults tested for SARS-CoV-2 by polymerase chain reaction in Northern Israel between March 2020-June 2022. We compared post-COVID QoL between those vaccinated against COVID-19 at the time of infection and those not, using an adjusted linear regression model, stratified by time elapsed since infection. Of 951 participants, mean EQ-5D Utility Index (EQ-5D UI) was 0·82 (SD = 0·26) and 0·83 (SD = 0·25) among the 227 double and 250 triple vaccinated respectively, compared to 0·76 (SD = 0·33) among those who received 0 dose (n = 243). In the adjusted model, previously infected individuals vaccinated with two or more doses reported a 0·05 increase in QoL score post- infection (CI = 0·01–0·10, p = 0·02) compared with those unvaccinated when infected. No association between vaccination and QoL was detected beyond 12 months post-infection. Vaccination with two or more doses of COVID19 vaccine, or at least the BNT162b2 vaccine, may partly mitigate QoL losses associated with post-acute COVID-19 symptoms, at least in the first 12 months post-infection.

Associations Between Reported Post-COVID-19 Symptoms and Subjective Well-Being, Israel, July 2021 -April 2022 (preprint)

The impact of individual symptoms reported post-COVID-19 on subjective well-being (SWB) is unknown. We described associations between SWB and selected reported symptoms following SARS-CoV-2 infection. We analysed reported symptoms and subjective well being from 2295 participants (of which 576 reporting previous infection) in an ongoing longitudinal cohort study taking place in Israel. We estimated changes in SWB associated with reported selected symptoms at three follow-up time points (3-6, 6-12, and 12-18 months post infection) among participants reporting previous SARS-CoV-2 infection, adjusted for key demographic variables, using linear regression. Our results suggest that the biggest and most sustained changes in SWB stems from non-specific symptoms (fatigue -7.7 percentage points (pp), confusion/ lack of concentration -10.7 pp, and sleep disorders -11.5pp, p<0.005), whereas the effect of system-specific symptoms, such as musculoskeletal symptoms (weakness in muscles and muscle pain) on SWB, are less profound and more transient. Taking a similar approach for other symptoms and following individuals over time to describe trends in SWB changes attributable to specific symptoms will help understand the post-acute phase of COVID-19 and how it should be defined and better managed.

Association between vaccination status and reported incidence of post-acute COVID-19 symptoms in Israel: a cross-sectional study of patients tested between March 2020 and November 2021 (preprint)

Background Long COVID is a post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection syndrome characterised by not recovering for several weeks or months following the acute episode. The effectiveness of COVID-19 vaccines against long-term symptoms of COVID-19 is not well understood. We determined whether vaccination was associated with the incidence of reporting long-term symptoms post-SARS-CoV-2 infection Methods We invited individuals who were PCR tested for SARS-CoV-2 infection at participating hospitals between March 2020-November 2021 to fill an online questionnaire that included baseline demographics, details of their acute episode and information about symptoms they were currently experiencing. Using binomial regression, we compared vaccinated individuals with those unvaccinated and those uninfected in terms of self-reported symptoms post-acute infection. Results We included 951 infected and 2437 uninfected individuals. Of the infected, 637(67%) were vaccinated. The most commonly reported symptoms were; fatigue (22%), headache (20%), weakness (13%), and persistent muscle pain (10%). After adjusting for follow-up time and baseline symptoms, those who received two doses less likely than unvaccinated individuals to report any of these symptoms by 64%, 54%, 57%, and 68% respectively, (Risk ratios 0.36, 0.46, 0.43, 0.32, p<0.04 in the listed sequence). Those who received two doses were no more likely to report any of these symptoms than individuals reporting no previous SARS-CoV-2 infection. Conclusions Vaccination with at least two doses of COVID-19 vaccine was associated with a substantial decrease in reporting the most common post-acute COVID-19 symptoms, bringing it back to baseline. Our results suggest that, in addition to reducing the risk of acute illness, COVID-19 vaccination may have a protective effect against long COVID.

Lessons Learned from a Pandemic: One Medical School’s Response to COVID-19 (preprint)

Background: The COVID-19 pandemic disrupted medical education. Social distancing prevented students from gathering in any setting. Teaching became less effective due to lack of staff, cancellation of procedures, transition to telehealth and shortages of personal protective equipment. Medical schools’ responses to previous lockdowns are not well documented. On March 13th 2020, all universities in Israel were closed and a transition to online learning was implemented. All clinical rotations were temporarily suspended. We describe changes to teaching and learning during the pandemic, and the evaluation of these changes.Methods: Several surveys were performed. Selected faculty members were asked to comment on the transition to online learning, and assess which practices could possibly be adopted for future use.Results: Overall satisfaction with online learning was high. High satisfaction was also reported regarding the delivery of online lectures, efficient transition to online teaching, and the maintenance of academic excellence despite the challenges of COVID-19. Twenty-three percent of medical students preferred to continue exclusive online learning in the future. Forty-five percent advocated for blended learning, mainly online. Selected challenges and opportunities are discussed.Conclusions: The rapid transition to online teaching and learning was successful. Lessons learned and recommendations for the future are presented.