Risk of Long COVID in People Infected With Severe Acute Respiratory Syndrome Coronavirus 2 After 2 Doses of a Coronavirus Disease 2019 Vaccine: Community-Based, Matched Cohort Study

  1. Daniel Ayoubkhani
  2. Matthew L Bosworth
  3. Sasha King
  4. Koen B Pouwels
  5. Myer Glickman
  6. Vahé Nafilyan
  7. Francesco Zaccardi
  8. Kamlesh Khunti
  9. Nisreen A Alwan
  10. A Sarah Walker

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Abstract

We investigated long COVID incidence by vaccination status in a random sample of UK adults from April 2020 to November 2021. Persistent symptoms were reported by 9.5% of 3090 breakthrough severe acute respiratory syndrome coronavirus 2 infections and 14.6% of unvaccinated controls (adjusted odds ratio, 0.59 [95% confidence interval, .50–.69]), emphasizing the need for public health initiatives to increase population-level vaccine uptake.

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  1. Version published to 10.1093/ofid/ofac464
  2. ScreenIT

    SciScore for 10.1101/2022.02.23.22271388: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical approval was obtained from the South Central Berkshire B Research Ethics Committee (20/SC/0195).
    Consent: At enrolment, adult participants provided written consent, including for optional weekly follow-up visits for one month followed by at least 12 monthly visits in the majority.
    Sex as a biological variablenot detected.
    RandomizationStudy data and design: The main data source was the UK COVID-19 Infection Survey (CIS, ISRCTN21086382, https://www.ndm.ox.ac.uk/covid-19/covid-19-infection-survey/protocol-and-information-sheets), comprising a sample of over half a million participants randomly selected from the UK community population.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    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:
    In particular, because the question on Long Covid was not introduced until 3 February 2021, shortly after mass COVID-19 vaccination started in the UK on 8 December 2020, one key limitation is that it was not possible to match double-vaccinated and unvaccinated participants on calendar time of infection (Supplementary Figure 1). Differences in the likelihood of developing Long Covid symptoms between exposure groups may therefore partly reflect changes in the dominant COVID-19 variant or other period effects. Our key exposure was double vaccination, despite third and booster doses now being available, and the study period was before the Omicron variant became widespread. We were not able to investigate participants who were single-vaccinated when infected because nearly all of these received their second dose within the 12-week follow-up period, confounding any relationship between one dose at infection and Long Covid symptoms. In conclusion, SARS-CoV-2 infection after double vaccination is associated with a reduced risk of developing Long Covid symptoms at 12 weeks compared with infection before vaccination, emphasising the need for public health initiatives to increase population-level vaccine uptake. Studies with longer follow-up are needed to assess the impact of booster doses and the Omicron variant and to evaluate symptom trajectories beyond a single 12-week follow-up visit, particularly given the relapsing nature of Long Covid [14]. Further research into possible biologi...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    ISRCTN21086382NANA

    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.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.02.23.22271388v1 on medRxiv