Population-Based Estimates of Post-acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection (PASC) Prevalence and Characteristics
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
Background
Emerging evidence suggests many people have persistent symptoms after acute coronavirus disease 2019 (COVID-19) illness. Our objective was to estimate the prevalence and correlates of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC).
Methods
We used a population-based probability survey of adults with COVID-19 in Michigan. Living noninstitutionalized adults aged ≥18 in the Michigan Disease Surveillance System with COVID-19 onset through mid-April 2020 were eligible for selection (N = 28 000). Among 2000 selected, 629 completed the survey between June–December 2020. We estimated PASC prevalence, defined as persistent symptoms ≥30 (30-day COVID-19) or ≥60 (60-day COVID-19) days post–COVID-19 onset, overall and by sociodemographic and clinical factors. We used modified Poisson regression to produce adjusted prevalence ratios (aPRs) for potential risk factors.
Results
The analytic sample (n = 593) was predominantly female (56.1%), aged ≥45 years (68.2%), and non-Hispanic White (46.3%) or Black (34.8%). Thirty- and 60-day COVID-19 were highly prevalent (52.5% and 35.0%), even among nonhospitalized respondents (43.7% and 26.9%) and respondents reporting mild symptoms (29.2% and 24.5%). Respondents reporting very severe (vs mild) symptoms had 2.25 times higher prevalence of 30-day COVID-19 (aPR, 2.25; 95% CI, 1.46–3.46) and 1.71 times higher prevalence of 60-day COVID-19 (aPR, 1.71; 95% CI: 1.02–2.88). Hospitalized (vs nonhospitalized) respondents had ~40% higher prevalence of both 30-day (aPR, 1.37; 95% CI: 1.12–1.69) and 60-day (aPR, 1.40; 95% CI: 1.02–1.93) COVID-19.
Conclusions
PASC is highly prevalent among cases reporting severe initial symptoms and, to a lesser extent, cases reporting mild and moderate symptoms.
Article activity feed
-
-
SciScore for 10.1101/2021.03.08.21252905: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The University of Michigan institutional review board reviewed the study and determined it was exempt from ongoing IRB review due to the use of secondary de-identified data. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Demographic correlates of interest included age group (18-34, 35-44, 45-54, 55-64, 65+), sex (male, female), race/ethnicity (Hispanic, Non-Hispanic (NH) White, NH Black, NH Other), and annual household income (<$35,000, $35,000-$74,999, $75,000+). Table 2: Resources
Software and Algorithms Sentences Resources We then used modified Poisson regression to examine unadjusted and adjusted … SciScore for 10.1101/2021.03.08.21252905: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The University of Michigan institutional review board reviewed the study and determined it was exempt from ongoing IRB review due to the use of secondary de-identified data. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Demographic correlates of interest included age group (18-34, 35-44, 45-54, 55-64, 65+), sex (male, female), race/ethnicity (Hispanic, Non-Hispanic (NH) White, NH Black, NH Other), and annual household income (<$35,000, $35,000-$74,999, $75,000+). Table 2: Resources
Software and Algorithms Sentences Resources We then used modified Poisson regression to examine unadjusted and adjusted prevalence ratios for demographic and clinical correlates of PASC. PASCsuggested: (PASC , RRID:SCR_016642)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has several limitations. Our sample includes individuals with COVID-19 onset early in the pandemic when access to testing was limited, which may bias our results in two ways. First, if severe cases are overrepresented in our sample, we may be overestimating the prevalence of PASC. Second, given the disproportionate lack of testing access for minority and low-income communities,31,32 our sample may underestimate sociodemographic disparities in PASC. Additionally, our data may be subject to both recall and response bias. Because respondents completed interviews between 10-36 weeks post COVID-19 onset, recall bias may be greater for respondents with a longer period between onset and survey completion. Furthermore, individuals with more severe disease or prolonged symptoms may be more likely to participate. Nevertheless, since the sampling frame includes all Michigan residents who tested positive, and symptoms among respondents ranged from mild to very severe, our sample is more comprehensive than previous studies.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
-
