Antecedent and persistent symptoms in COVID-19 and other respiratory illnesses: Insights from prospectively collected data in the BRACE trial
Year: 2024
Type: article
Abstract: 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.
Source: Journal of Infection
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, Kirsten P. Perrett, Jeffrey J. Post, Cristina Prat-Aymerich, Lynne E. Quinn, Peter C. Richmond, Nicholas J. Wood, Nicole L. Messina, Nigel Curtis
Institutions: Murdoch Children's Research Institute, The University of Melbourne, University Hospital of Geneva, Royal Adelaide Hospital, South Australian Health and Medical Research Institute, Utrecht University, University Medical Center Utrecht, Ecraid Foundation (Netherlands), University of Exeter, Universidade Federal de Mato Grosso do Sul, Yale University, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública, Fundação de Medicina Tropical, Royal Children's Hospital, The University of Texas Medical Branch at Galveston, The University of Western Australia, Princess Margaret Hospital for Children, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Perth Children's Hospital, Flinders University, The Kids Research Institute Australia, Fiona Stanley Hospital, UNSW Sydney, Prince of Wales Hospital, The University of Sydney, Sydney Children's Hospital, Sydney Children’s Hospitals Network, National Centre for Immunisation Research & Surveillance
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,030
Funders: National Science Foundation, Bill and Melinda Gates Foundation, Children’s Hospital of Wisconsin Research Institute, Children's Hospital Foundation, Murdoch Children's Research Institute, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, State Government of Victoria, Minderoo Foundation, Medical Research Council, National Health and Medical Research Council
Awards: Murdoch Childrens Research Institute - to evaluate the potential of the Bacillus Calmette-Guérin vaccine to protect against COVID-19 disease and to further understanding of how Bacillus ..., Exploring the heterologous effect of vaccination, Improving the diagnosis, treatment and prevention of infectious diseases in children, G3660576293, G3816067056
OpenAlex ID: W4402291352