ABSTRACT
Objectives: In this retrospective cohort study, we aimed to investigate symptom severity change following COVID-19 vaccination among post COVID-19 condition (PCC) patients on Bonaire. Methods: Symptomatic cases who tested positive for SARS-CoV-2 between the start of the pandemic and 1 October 2021, were unrecovered on the interview day, and unvaccinated prior to infection were identified from the national case registry. Patients were interviewed by telephone between 15 November and 4 December 2021 about sociodemographic factors, pre-pandemic health, COVID-19 symptoms and vaccination status. We compared symptom severity change between the acute and post-acute disease phase (>4 weeks after disease onset) of 14 symptoms on a five-point Likert scale for 36 PCC patients having received at least one dose of the BNT162 (BioNTech/Pfizer) vaccine and 11 patients who remained unvaccinated, using separate multiple linear regression models. Results: Most common post-acute symptoms included fatigue (81%), reduced physical endurance (79%), and reduced muscle strength (64%). Post-infection vaccination was significantly associated with reduced severity of heart palpitations, after adjusting for acute phase severity and duration of illness ({beta} 0.60, 95% CI 0.18, 1.02). We did not find a statistically significant association with symptom severity change for other, more prevalent symptoms. Conclusions: Larger prospective studies are needed to confirm our observation in a small study population that post-infection COVID-19 vaccination was associated with reduced severity of heart palpitations among those with this symptom self-attributed to SARS-CoV-2 infection.
Subject(s)
COVID-19 , Heart Diseases , FatigueABSTRACT
Aim: To assess the prevalence of post COVID-19 condition (PCC) on Bonaire and develop a practical risk scoring tool for PCC screening, using easily obtainable characteristics. Methods: A retrospective cohort study of symptomatic SARS-CoV-2 cases were randomly sampled from Bonaire their case-registry and telephone interviewed between 15-November-2021 and 4-December-2021. PCC patients had a PCR-positive SARS-CoV-2 test (1-March-2020 and 1-October-2021) and self-attributed at least one symptom lasting over four weeks to their infection. Multivariate logistic regression was used to derive a risk formula to develop a practical risk scoring tool. Results: Out of 414 cases, 160 (39%) were PCC patients. Fifty-three patients were unrecovered (median illness duration 250 days (IQR 34)). Of recovered patients, 35% experienced symptoms for at least 3 months after disease onset. PCC prevalence was highest among females (38%), 40-59 year-olds (40%), morbidly obese (31%) and hospitalized patients (80%). A PCC risk scoring tool using age, sex, presence of comorbidities, and acute phase hospitalization or GP visit had an area-under-the-curve (AUC) of 0.68 (95%CI 0.63-0.74). Adding smoking, alcohol use, BMI, education level, and number of acute phase symptoms increased the AUC to 0.79 (95%CI 0.74- 0.83). Subgroup analyses of non-hospitalized patients (n=362) resulted in similar AUCs. Conclusion: Thee estimated prevalence of PCC on Bonaire was 39%. Moreover, easily obtainable patient characteristics can be used to build a risk scoring tool for PCC with acceptable discriminatory power. After external validation, this tool could aid the development of healthcare interventions in low resource settings to identify patients at risk for PCC.
Subject(s)
COVID-19 , ObesityABSTRACT
Background: Severity of SARS-CoV-2 infection may vary over time. Here, we estimate age-specific risks of hospitalization, ICU admission and death given infection in the Netherlands from February 2020 - June 2021. Methods: A nationwide longitudinal serology study was used to estimate numbers of infections in three epidemic periods (February 2020 - June 2020, July 2020 - February 2021, March 2021 - June 2021). We accounted for reinfections and, as vaccination started in January 2021, breakthrough infections among vaccinated persons. Severity estimates were inferred by combining numbers of infections with aligned numbers of hospitalizations and ICU admissions from a national hospital-based registry, and aligned numbers of deaths based on national excess all-cause mortality estimates. Results: In each period there was a nearly consistent pattern of accelerating, almost exponential, increase in severity of infection with age. The rate of increase with age was highest for death and lowest for hospitalization. In the first period, the overall risk of hospitalization, ICU admission and death were 1.5% (95%-confidence interval [CI] 1.3-1.8%), 0.36% (95%-CI: 0.31-0.42%) and 1.2% (95%-CI: 1.0-1.4), respectively. The risk of hospitalization was higher in the following periods, while the risk of ICU admission remained stable. The risk of death decreased over time, with a substantial drop among [≥]70-years-olds in February 2021 - June 2021. Conclusion: The accelerating increase in severity of SARS-CoV-2 with age remained intact during the first three epidemic periods in the Netherlands. The substantial drop in risk of death among elderly in the third period coincided with the introduction of COVID-19 vaccination.