ABSTRACT
Background: Post-COVID conditions after infection with new SARS-CoV-2 variants have been incompletely described. We compared the prevalence and risk factors for ongoing symptoms lasting 4 weeks or longer (often referred to as post-COVID Conditions) among adults who had tested positive vs. negative during the Delta and early-Omicron periods. Methods: Self-reported survey data regarding symptoms and previous SARS-CoV-2 test results were collected from May 31 - July 6, 2022, from a probability sampling of United States adults. Respondents were classified according to their test result, predominant circulating variant when respondents first tested positive (Delta vs early-Omicron), and demographic risk factors. Results: Among 2,421 respondents, 256 tested positive during Delta, 460 during early-Omicron, and 1,705 always tested negative. Nearly one-fourth (22.3%) of negative respondents reported at least 1 symptom that lasted 4 or more weeks, compared to 60.6% (p<0.05) of respondents who tested positive during the Delta period and 47.8% (p<0.05) during the early-Omicron period. Fatigue, change in smell/taste, and cough were commonly reported by respondents who tested positive. Demographic risk factors associated with ongoing symptoms were being female and unemployed (aOR 1.28, 95% CI 1.06-1.55; aOR 1.48, 95% CI: 1.17-1.87). Conclusion: The reported occurrence of ongoing symptoms associated with post-COVID conditions was reduced during the early-Omicron period, compared with Delta.
ABSTRACT
Introduction: Although SARS-CoV-2 vaccines were first approved under Emergency Use Authorization by the FDA in late 2020 for adults, approval for young children 6 months to < 5 years of age did not occur until 2022. Understanding real world vaccine effectiveness in the setting of emerging variants is critical. The primary goal of this study is to evaluate SARS-CoV-2 vaccine effectiveness (VE) against infection among children aged >6 months and adults aged <50 years. Methods: CASCADIA is a four-year community-based prospective study of SARS-CoV-2 VE among adult and pediatric populations aged 6 months to 49 years in Oregon and Washington. At enrollment and regular intervals, participants complete a sociodemographic questionnaire. Individuals may provide a blood sample at enrollment and annually thereafter, with additional, optional blood draws after infection and vaccination. Participants complete weekly self-collection of anterior nasal swabs and symptom questionnaires. Swabs are tested for SARS-CoV-2 and other respiratory pathogens by RT-PCR, with results of selected pathogens returned to participants; nasal swabs with SARS-CoV-2 detected will undergo whole genome sequencing. Participants who report symptoms outside of their weekly swab collection and symptom survey are asked to collect an additional swab. Participants who test positive for SARS-CoV-2 undergo serial swab collection every three days for three weeks. Serum samples are tested for SARS-CoV-2 antibody by binding and neutralization assays. Analysis: Cox regression models will be used to estimate the hazard ratio associated with SARS-CoV-2 vaccination among the pediatric and adult population, controlling for demographic factors and potential confounders, including clustering within households.