传染病与治疗杂志

抽象的

Duration of COVID-19 and Predictors for Long COVID: A Retrospective US Healthcare Database Analysis

Brandon J. Patterson, Jill W. Ruppenkamp, Fayolah Richards, Ronita Debnath, Antoine C. El Khoury, Jessica K. deMartino, Brahim Bookhart, Chantal E. Holy, Paul M. Coplan

Background: Risks of Ongoing Symptomatic COVID-19 (OSC) and Post-acute COVID-19 Syndrome (PCS), following COVID-19 infection, are not well documented. Our study evaluated those risks based on patient and COVID-19 Signs and Symptoms (CSS).

Methods: Patients with COVID-19 (first date=index) from April 1, 2020, to June 30, 2021, and ≥ 6 months of continuous enrollment pre- and post-index, in IBM® MarketScan® Commercial and Medicare Supplemental databases, were identified and stratified by severity during the disease’s acute phase, using mild, moderate and Severe/Critical (SC) algorithms defined by the Janssen COVID-19 vaccine Phase 3 Trial. Variables included demographics, comorbidities, and individual CSS. Patients with OSC (COVID-19 disease duration >4 weeks) or PCS (COVID-19 disease duration >12 weeks) were identified. Logistic regression analyses were conducted to identify risk factors for PCS across all COVID-19 patients and within each severity group.

Results: 383,883 patients (160,326 mild (DoD: 18.8 days (standard deviation (SD): 15.3)); 189,240 moderate (DoD: 27.9 days (SD: 30.8)); 34,317 SC cases (DoD: 60.7 days (SD: 67.0)))were included. The percentage of patients with OSC and PCS in the mild, moderate and severe cohort was as follows: 11.8% and 0.6%, 25.2% and 3.6%, and 41.4% and 19.5%, respectively. Patients with PCS, suffered mostly from continued shortness of breath and malaise (24% and 16%, respectively). In the overall COVID-19 population, the main risk factors for PCS was severity at time of acute disease (OR for PCS in severe vs. mild population: 3.113, (95%CI: 2.336-4.149), OR for PCS in moderate vs. mild population: 1.911 (95%CI: 1.838-1.988)); CSS associated with increased risk of PCS, included somnolence: OR: 1.911 (95%CI: 1.838-1.988) and thrombosis: OR: 1.787 (95%CI: 1.717-1.860).

Conclusions: PCS affected nearly one in 5 patients with severe or critical COVID-19 at time of acute infection.