Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT
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Abstract
Clinical presentation, outcomes, and duration of COVID-19 has ranged dramatically. While some individuals recover quickly, others suffer from persistent symptoms, collectively known as long COVID, or post - acute sequelae of SARS-CoV-2 (PASC). Most PASC research has focused on hospitalized COVID-19 patients with moderate to severe disease. We used data from a diverse population-based cohort of Arizonans to estimate prevalence of PASC, defined as experiencing at least one symptom 30 days or longer, and prevalence of individual symptoms. There were 303 non-hospitalized individuals with a positive lab-confirmed COVID-19 test who were followed for a median of 61 days (range 30–250). COVID-19 positive participants were mostly female (70%), non-Hispanic white (68%), and on average 44 years old. Prevalence of PASC at 30 days post-infection was 68.7% (95% confidence interval: 63.4, 73.9). The most common symptoms were fatigue (37.5%), shortness-of-breath (37.5%), brain fog (30.8%), and stress/anxiety (30.8%). The median number of symptoms was 3 (range 1–20). Amongst 157 participants with longer follow-up (≥60 days), PASC prevalence was 77.1%.
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SciScore for 10.1101/2021.03.29.21254588: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Informed consent was obtained from all participants.
IRB: Ethics approval was obtained from the University of Arizona Institutional Review Board (Protocol #2003521636A002).Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources First, to account for potential dropout bias, where participants lost to follow-up may be less likely to experience PASC, we used multiple imputation (MI) with a delta adjustment, decreasing the likelihood of dropouts experiencing PASC by delta = 25%, 50%, and 75% (3). PASCsuggested: (PASC , RRID:SCR_016642)Results…
SciScore for 10.1101/2021.03.29.21254588: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Informed consent was obtained from all participants.
IRB: Ethics approval was obtained from the University of Arizona Institutional Review Board (Protocol #2003521636A002).Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources First, to account for potential dropout bias, where participants lost to follow-up may be less likely to experience PASC, we used multiple imputation (MI) with a delta adjustment, decreasing the likelihood of dropouts experiencing PASC by delta = 25%, 50%, and 75% (3). 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 also has limitations. Our response rate at follow-up was low (56%), and participants who completed follow-up questionnaires may differ from those who did not, possibly with a bias towards people who suffer from PASC. However, reported severity and having a pre-existing condition, both of which were associated with PASC, were similar between participants with and without follow-up. It is also possible that individuals suffering from severe PASC were too ill to complete follow-up surveys. We conducted a statistically principled sensitivity analysis for loss to follow-up, and still estimated a high prevalence of PASC (47.7% (delta=75%)). Our characterization of the PASC phenotype is limited to 25 symptoms; other researchers have included more symptoms in their assessment(9). Finally, we may have been underpowered to detect differences. COVID-19 has infected more than 110,000,000 individuals worldwide as of 1 March 2021 (10). If 63% (the lower limit of our 95% CI) of survivors experience persistent symptoms, over 63,000,000 individuals could be affected by the long-term consequences of COVID-19. Our estimate at ≥60 days follow-up showed that 50% of our participants were suffering from of 3 or more symptoms, with 25% experiencing 7 or more symptoms. These figures portend a public health challenge of massive scale. Further research is needed to characterize the clinical spectrum of PASC more completely in a variety of populations, including investigating correlates of PAS...
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.
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