Ellie McDonald , Laure F. Pittet , Simone E. Barry , Marc Bonten , John Campbell , Julio Croda , Mariana G. Croda , Margareth Pretti Dalcolmo , Andrew Davidson , Fernando F. de Almeida e Val , Glauce dos Santos , Kaya Gardiner , Grace Gell , Amanda Gwee , Ann Krastev , Marcus Vinícius Guimaraes Lacerda , Michaela Lucas , David J. Lynn , Laurens Manning , Nick McPhate , Nigel Curtis
{"title":"COVID-19 和其他呼吸道疾病的前驱症状和持续症状：从 BRACE 试验的前瞻性数据中获得的启示。","authors":"Ellie McDonald , Laure F. Pittet , Simone E. Barry , Marc Bonten , John Campbell , Julio Croda , Mariana G. Croda , Margareth Pretti Dalcolmo , Andrew Davidson , Fernando F. de Almeida e Val , Glauce dos Santos , Kaya Gardiner , Grace Gell , Amanda Gwee , Ann Krastev , Marcus Vinícius Guimaraes Lacerda , Michaela Lucas , David J. Lynn , Laurens Manning , Nick McPhate , Nigel Curtis","doi":"10.1016/j.jinf.2024.106267","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Some individuals have a persistence of symptoms following both COVID-19 (post-acute COVID-19 syndrome; PACS) and other viral infections. This study used prospectively collected data from an international trial to compare symptoms following COVID-19 and non-COVID-19 respiratory illness, to identify factors associated with the risk of PACS, and to explore symptom patterns before and after COVID-19 and non-COVID-19 respiratory illnesses.</div></div><div><h3>Methods</h3><div>Data from a multicentre randomised controlled trial (BRACE trial) involving healthcare workers across four countries were analysed. Symptom data were prospectively collected over 12 months, allowing detailed characterisation of symptom patterns. Participants with COVID-19 and non-COVID-19 respiratory illness episodes were compared, focussing on symptom severity, duration (including PACS using NICE and WHO definitions), and pre-existing symptoms.</div></div><div><h3>Findings</h3><div>Compared to those with a non-COVID-19 illness, participants with COVID-19 had significantly more severe illness (OR 7·4, 95%CI 5·6–9·7). Symptom duration meeting PACS definitions occurred in a higher proportion of COVID-19 cases than non-COVID-19 respiratory controls using both the NICE definition (2·5% vs 0·5%, OR 6·6, 95%CI 2·4–18·3) and the WHO definition (8·8% vs 3·7%, OR 2·5, 95%CI 1·4–4·3). When considering only participants with COVID-19, age 40-59 years (aOR 2·8, 95%CI 1·3–6·2), chronic respiratory disease (aOR 5·5, 95%CI 1·3–23·1), and pre-existing symptoms (aOR 3·0, 95%CI 1·4–6·3) were associated with an increased risk of developing PACS. Symptoms associated with PACS were also reported by participants in the months preceding their COVID-19 or non-COVID-19 respiratory illnesses (32% fatigue and muscle ache, 11% intermittent cough and shortness of breath).</div></div><div><h3>Interpretation</h3><div>Healthcare workers with COVID-19 were more likely to have severe and longer-lasting symptoms than those with a non-COVID-19 respiratory illness, with a higher proportion meeting the WHO or NICE definitions of PACS. Age, chronic respiratory disease, and pre-existing symptoms increased the risk of developing PACS following COVID-19.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"89 5","pages":"Article 106267"},"PeriodicalIF":10.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Antecedent and persistent symptoms in COVID-19 and other respiratory illnesses: Insights from prospectively collected data in the BRACE trial\",\"authors\":\"Ellie McDonald , Laure F. Pittet , Simone E. Barry , Marc Bonten , John Campbell , Julio Croda , Mariana G. Croda , Margareth Pretti Dalcolmo , Andrew Davidson , Fernando F. de Almeida e Val , Glauce dos Santos , Kaya Gardiner , Grace Gell , Amanda Gwee , Ann Krastev , Marcus Vinícius Guimaraes Lacerda , Michaela Lucas , David J. Lynn , Laurens Manning , Nick McPhate , Nigel Curtis\",\"doi\":\"10.1016/j.jinf.2024.106267\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Some individuals have a persistence of symptoms following both COVID-19 (post-acute COVID-19 syndrome; PACS) and other viral infections. This study used prospectively collected data from an international trial to compare symptoms following COVID-19 and non-COVID-19 respiratory illness, to identify factors associated with the risk of PACS, and to explore symptom patterns before and after COVID-19 and non-COVID-19 respiratory illnesses.</div></div><div><h3>Methods</h3><div>Data from a multicentre randomised controlled trial (BRACE trial) involving healthcare workers across four countries were analysed. Symptom data were prospectively collected over 12 months, allowing detailed characterisation of symptom patterns. Participants with COVID-19 and non-COVID-19 respiratory illness episodes were compared, focussing on symptom severity, duration (including PACS using NICE and WHO definitions), and pre-existing symptoms.</div></div><div><h3>Findings</h3><div>Compared to those with a non-COVID-19 illness, participants with COVID-19 had significantly more severe illness (OR 7·4, 95%CI 5·6–9·7). Symptom duration meeting PACS definitions occurred in a higher proportion of COVID-19 cases than non-COVID-19 respiratory controls using both the NICE definition (2·5% vs 0·5%, OR 6·6, 95%CI 2·4–18·3) and the WHO definition (8·8% vs 3·7%, OR 2·5, 95%CI 1·4–4·3). When considering only participants with COVID-19, age 40-59 years (aOR 2·8, 95%CI 1·3–6·2), chronic respiratory disease (aOR 5·5, 95%CI 1·3–23·1), and pre-existing symptoms (aOR 3·0, 95%CI 1·4–6·3) were associated with an increased risk of developing PACS. Symptoms associated with PACS were also reported by participants in the months preceding their COVID-19 or non-COVID-19 respiratory illnesses (32% fatigue and muscle ache, 11% intermittent cough and shortness of breath).</div></div><div><h3>Interpretation</h3><div>Healthcare workers with COVID-19 were more likely to have severe and longer-lasting symptoms than those with a non-COVID-19 respiratory illness, with a higher proportion meeting the WHO or NICE definitions of PACS. Age, chronic respiratory disease, and pre-existing symptoms increased the risk of developing PACS following COVID-19.</div></div>\",\"PeriodicalId\":50180,\"journal\":{\"name\":\"Journal of Infection\",\"volume\":\"89 5\",\"pages\":\"Article 106267\"},\"PeriodicalIF\":10.0000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0163445324002019\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0163445324002019","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/6 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Antecedent and persistent symptoms in COVID-19 and other respiratory illnesses: Insights from prospectively collected data in the BRACE trial
Background
Some individuals have a persistence of symptoms following both COVID-19 (post-acute COVID-19 syndrome; PACS) and other viral infections. This study used prospectively collected data from an international trial to compare symptoms following COVID-19 and non-COVID-19 respiratory illness, to identify factors associated with the risk of PACS, and to explore symptom patterns before and after COVID-19 and non-COVID-19 respiratory illnesses.
Methods
Data from a multicentre randomised controlled trial (BRACE trial) involving healthcare workers across four countries were analysed. Symptom data were prospectively collected over 12 months, allowing detailed characterisation of symptom patterns. Participants with COVID-19 and non-COVID-19 respiratory illness episodes were compared, focussing on symptom severity, duration (including PACS using NICE and WHO definitions), and pre-existing symptoms.
Findings
Compared to those with a non-COVID-19 illness, participants with COVID-19 had significantly more severe illness (OR 7·4, 95%CI 5·6–9·7). Symptom duration meeting PACS definitions occurred in a higher proportion of COVID-19 cases than non-COVID-19 respiratory controls using both the NICE definition (2·5% vs 0·5%, OR 6·6, 95%CI 2·4–18·3) and the WHO definition (8·8% vs 3·7%, OR 2·5, 95%CI 1·4–4·3). When considering only participants with COVID-19, age 40-59 years (aOR 2·8, 95%CI 1·3–6·2), chronic respiratory disease (aOR 5·5, 95%CI 1·3–23·1), and pre-existing symptoms (aOR 3·0, 95%CI 1·4–6·3) were associated with an increased risk of developing PACS. Symptoms associated with PACS were also reported by participants in the months preceding their COVID-19 or non-COVID-19 respiratory illnesses (32% fatigue and muscle ache, 11% intermittent cough and shortness of breath).
Interpretation
Healthcare workers with COVID-19 were more likely to have severe and longer-lasting symptoms than those with a non-COVID-19 respiratory illness, with a higher proportion meeting the WHO or NICE definitions of PACS. Age, chronic respiratory disease, and pre-existing symptoms increased the risk of developing PACS following COVID-19.
期刊介绍：
The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection.
Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.
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