RISK FACTORS ASSOCIATED WITH THE CLINICAL OUTCOMES OF ACUTE AND POST-ACUTE COVID-19 IN ADULT PATIENTS
Journal of General Internal Medicine
; 37:S320, 2022.
Artigo
em Inglês
| EMBASE | ID: covidwho-1995699
ABSTRACT
BACKGROUND:
During the COVID-19 pandemic, most attention has been focused on the acute phase of the disease, but lingering symptoms from the postacute sequelae of COVID-19 (PASC) merit concern. The George Washington University COVID-19 Recovery Clinic is documenting these presentations to better understand PASC and its precipitating factors. The group implemented definitions for six phenotype categories pulmonary, cardiac, connective tissue, vascular, central nervous system (CNS), and other. This research seeks to identify pre-existing factors that could affect disease severity, understand their effect on PASC symptoms at 6-15 months post-infection, and determine associations between patient history and PASC phenotypes.METHODS:
An IRB-approved, retrospective cohort study was performed from charts of adult patients with persistent symptoms after acute COVID-19. Data were ed from clinical history prior to COVID-19 diagnosis, during acute COVID-19, and during the post-acute phase, including laboratory results and responses from mental health assessment tools. PASC phenotypes were determined clinically and hospitalization was used as a proxy for disease severity. Descriptive statistics, unadjusted odds ratios, and significance tests (Fisher's exact test, Chi-square test, and Mann-Whitney U test) were calculated using RStudio (4.1.1).RESULTS:
Study participants with persistent symptoms at 6-15 months postinfection (n=116) had a mean age of 45.16 (SD 13.23), of which 70% were female, 60% were Caucasian, 12% were African-American, 9% were Asian, and 3% were Hispanic/Latino. When including all patients who had persistent symptoms at 1-15 months post-infection, those with obesity (BMI ≥30) or type 2 diabetes were much more likely to undergo a severe acute phase of COVID19 (OR 12.75;95% CI 1.91-84.95;p=0.02;n=61 and OR 34.67;95% CI 4.43-271.46;p<0.001;n=61 respectively). At 6-15 months post-infection, those suffering from a pulmonary PASC phenotype were more likely to have smoked (OR 3.27;95% CI 1.18-9.11;p=0.02;n=91). At the same period, those presenting with at least one CNS phenotype had a significantly higher level of C-reactive protein (CRP) than those without a CNS phenotype presentation (Mean 3.70 mg/L, SD 5.19 vs. Mean 1.26 mg/L, SD 2.36;p=0.009;n=53). Additionally, acute phase severity was not significantly associated with the presence of PASC.CONCLUSIONS:
Our research further demonstrates the increased risk of severe acute COVID-19 among patients with obesity and type 2 diabetes. Furthermore, we show that those with a smoking history were more likely to continue to have pulmonary symptoms of COVID-19 at 6-15 months postinfection. Additionally, our study suggests that there may be a relationship between CRP and persistent CNS symptoms. A better understanding of these associations can help predict the full burden of COVID-19 and improve clinical guidance.
C reactive protein; endogenous compound; adult; African American; body mass; Caucasian; central nervous system; clinical outcome; cohort analysis; complication; conference abstract; controlled study; coronavirus disease 2019; female; gene expression; Hispanic; hospitalization; human; long COVID; lung disease; major clinical study; male; medical history; mental health; middle aged; non insulin dependent diabetes mellitus; obesity; outcome assessment; phenotype; protein expression; rank sum test; retrospective study; risk factor; smoking; statistical significance
Texto completo:
Disponível
Coleções:
Bases de dados de organismos internacionais
Base de dados:
EMBASE
Tipo de estudo:
Estudo prognóstico
Tópicos:
Covid persistente
Idioma:
Inglês
Revista:
Journal of General Internal Medicine
Ano de publicação:
2022
Tipo de documento:
Artigo
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