TY - JOUR
T1 - COVID-19 Patient-Reported Symptoms Using FLU-PRO Plus in a Cohort Study
T2 - Associations with Infecting Genotype, Vaccine History, and Return to Health
AU - EPICC COVID-19 Cohort Study Group
AU - Richard, Stephanie A.
AU - Epsi, Nusrat J.
AU - Lindholm, David A.
AU - Malloy, Allison M.W.
AU - Maves, Ryan C.
AU - Berjohn, Catherine M.
AU - Lalani, Tahaniyat
AU - Smith, Alfred G.
AU - Mody, Rupal M.
AU - Ganesan, Anuradha
AU - Huprikar, Nikhil
AU - Colombo, Rhonda E.
AU - Colombo, Christopher J.
AU - Madar, Cristian
AU - Jones, Milissa U.
AU - Larson, Derek T.
AU - Ewers, Evan C.
AU - Bazan, Samantha
AU - Fries, Anthony C.
AU - Maldonado, Carlos J.
AU - Simons, Mark P.
AU - Rozman, Julia S.
AU - Andronescu, Liana
AU - Mende, Katrin
AU - Tribble, David R.
AU - Agan, Brian K.
AU - Burgess, Timothy H.
AU - Pollett, Simon D.
AU - Powers, John H.
AU - Cowden, J.
AU - Darling, M.
AU - Deleon, S.
AU - Markelz, A.
AU - Mende, K.
AU - Merritt, S.
AU - Merritt, T.
AU - Turner, N.
AU - Wellington, T.
AU - Bazan, S.
AU - Mount, C.
AU - Stein, M.
AU - Berjohn, C.
AU - Burgess, T.
AU - Byrne, C.
AU - Chung, K.
AU - Olsen, C.
AU - Richard, S.
AU - Rusiecki, J.
AU - Scher, A.
AU - Schofield, C.
N1 - Funding Information:
We appreciate the EPICC participants for their central role in this study. Many thanks to the IDCRP team at the clinical research sites 'physician/ clinical investigators, site managers, regulatory staff, clinical research coordinators, and laboratory personnel' for their support of this study and contributions to its success under very challenging circumstances.
Publisher Copyright:
© 2022 Published by Oxford University Press on behalf of the Infectious Diseases Society of America.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Background: Patient-reported outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are an important measure of the full burden of coronavirus disease (COVID). Here, we examine how (1) infecting genotype and COVID-19 vaccination correlate with inFLUenza Patient-Reported Outcome (FLU-PRO) Plus score, including by symptom domains, and (2) FLU-PRO Plus scores predict return to usual activities and health. Methods: The epidemiology, immunology, and clinical characteristics of pandemic infectious diseases (EPICC) study was implemented to describe the short- and long-term consequences of SARS-CoV-2 infection in a longitudinal, observational cohort. Multivariable linear regression models were run with FLU-PRO Plus scores as the outcome variable, and multivariable Cox proportional hazards models evaluated effects of FLU-PRO Plus scores on return to usual health or activities. Results: Among the 764 participants included in this analysis, 63% were 18-44 years old, 40% were female, and 51% were White. Being fully vaccinated was associated with lower total scores (β = -0.39; 95% CI, -0.57 to -0.21). The Delta variant was associated with higher total scores (β = 0.25; 95% CI, 0.05 to 0.45). Participants with higher FLU-PRO Plus scores were less likely to report returning to usual health and activities (health: hazard ratio [HR], 0.46; 95% CI, 0.37 to 0.57; activities: HR, 0.56; 95% CI, 0.47 to 0.67). Fully vaccinated participants were more likely to report returning to usual activities (HR, 1.24; 95% CI, 1.04 to 1.48). Conclusions: Full SARS-CoV-2 vaccination is associated with decreased severity of patient-reported symptoms across multiple domains, which in turn is likely to be associated with earlier return to usual activities. In addition, infection with the Delta variant was associated with higher FLU-PRO Plus scores than previous variants, even after controlling for vaccination status.
AB - Background: Patient-reported outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are an important measure of the full burden of coronavirus disease (COVID). Here, we examine how (1) infecting genotype and COVID-19 vaccination correlate with inFLUenza Patient-Reported Outcome (FLU-PRO) Plus score, including by symptom domains, and (2) FLU-PRO Plus scores predict return to usual activities and health. Methods: The epidemiology, immunology, and clinical characteristics of pandemic infectious diseases (EPICC) study was implemented to describe the short- and long-term consequences of SARS-CoV-2 infection in a longitudinal, observational cohort. Multivariable linear regression models were run with FLU-PRO Plus scores as the outcome variable, and multivariable Cox proportional hazards models evaluated effects of FLU-PRO Plus scores on return to usual health or activities. Results: Among the 764 participants included in this analysis, 63% were 18-44 years old, 40% were female, and 51% were White. Being fully vaccinated was associated with lower total scores (β = -0.39; 95% CI, -0.57 to -0.21). The Delta variant was associated with higher total scores (β = 0.25; 95% CI, 0.05 to 0.45). Participants with higher FLU-PRO Plus scores were less likely to report returning to usual health and activities (health: hazard ratio [HR], 0.46; 95% CI, 0.37 to 0.57; activities: HR, 0.56; 95% CI, 0.47 to 0.67). Fully vaccinated participants were more likely to report returning to usual activities (HR, 1.24; 95% CI, 1.04 to 1.48). Conclusions: Full SARS-CoV-2 vaccination is associated with decreased severity of patient-reported symptoms across multiple domains, which in turn is likely to be associated with earlier return to usual activities. In addition, infection with the Delta variant was associated with higher FLU-PRO Plus scores than previous variants, even after controlling for vaccination status.
KW - COVID-19
KW - SARS-CoV-2
KW - patient-reported outcomes
KW - symptoms
KW - vaccine breakthrough
UR - http://www.scopus.com/inward/record.url?scp=85136259877&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofac275
DO - 10.1093/ofid/ofac275
M3 - Article
AN - SCOPUS:85136259877
SN - 2328-8957
VL - 9
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 7
M1 - ofac275
ER -