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Long Covid Symptom Clusters, Correlates and Predictors in a Highly Vaccinated Australian Population in 2023

IF 3.2 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-05-08 DOI:10.1111/hex.70273

Essa Tawfiq, Rosalie Chen, Damian Alexander Honeyman, Rebecca Dawson, Mohana Kunasekaran, Adriana Notaras, Deepti Gurdasani, Helen Skouteris, Darshini Ayton, Chandini Raina MacIntyre

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引用次数: 0

Abstract

Background

Limited data exists regarding long Covid burden following Omicron infection in highly vaccinated populations.

Objective

To (1) characterise long Covid prevalence and predictors and (2) identify key symptom clusters and their correlates among long Covid patients, during an Omicron-predominant period in a highly vaccinated population.

Design

Anonymous, online, cross-sectional survey.

Setting

January 2023, Australia.

Participants

Residents aged ≥ 18 years with self-reported history of test-positive Covid-19.

The main variables studied were socio-demographic characteristics, Covid-19 risk factors, vaccination, infection history and experiences with long Covid.

Main Outcome Measures

Long Covid symptoms. Symptom-based clustering was used to identify long Covid symptom clusters and their functional correlates. Predictors of long Covid occurrence and severity were assessed using multivariable logistic regression.

Results

Overall, 240/1205 participants (19.9%) reported long Covid. Long Covid risk was significantly higher for women OR 1.71 (95% CI: 1.17–2.51), people with comorbidities 2.19 (95% CI: 1.56–3.08) and those using steroid inhalers for Covid-19 treatment (2.34 [95% CI: 1.29–4.24]). Long-Covid risk increased with increasing Covid-19 infection severity (moderately severe symptoms: 2.23 [95% CI: 1.50–3.30], extremely severe symptoms: 5.80 [95% CI: 3.48–9.66], presented to ED/hospitalised: 7.22 [95% CI: 3.06–17.03]). We found no significant difference in the likelihood of long Covid between the Omicron and pre-Omicron periods, vaccination status and participant age.

We identified two long Covid clusters (pauci-symptomatic, n = 170, vs. polysymptomatic, n = 66). Polysymptomatic cluster membership was associated with worse functioning (impacts on work, moderate activity, emotions and energy). Severity acute infection was strongly predictive of polysymptomatic cluster membership (5.72 [2.04–17.58]). Monoclonal antibody treatment was strongly associated with pauci-symptomatic cluster membership (0.02 [0.00–0.13]).

Discussion

Our study shows that long Covid is an important health burden in Australia, including during the Omicron era, and identifies several risk factors. We found a subgroup of patients characterised by more symptoms and worse functional outcomes. Our findings can inform policies for protecting vulnerable populations and frameworks for long Covid risk assessment and management.

Conclusions

One-in-five people may suffer long Covid after acute Covid-19 infection, with similar risk across age groups. Omicron variants appear not to have a lower risk compared to earlier variants in our study. A cumulative number of symptoms can help triage long Covid patients.

Patient or Public Contribution

We did not involve patients or the public in the design of the questionnaire. However, after a soft launch, we revised some survey questions by reviewing early responses from patients and the public.

Abstract Image

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2023年澳大利亚高度接种疫苗人群中的长冠状病毒症状群、相关因素和预测因素

背景：在高度接种疫苗的人群中，关于Omicron感染后的长期Covid负担的数据有限。目的：(1)表征长冠肺炎的流行和预测因素；(2)在高度接种人群中，确定长冠肺炎患者在欧米克隆显性时期的关键症状群及其相关性。设计匿名、在线、横断面调查。2023年1月，澳大利亚。参与者年龄≥18岁，自述有Covid-19检测阳性病史的居民。研究的主要变量为社会人口学特征、Covid-19危险因素、疫苗接种、感染史和长期Covid经历。主要结局指标：长冠状病毒症状。基于症状的聚类方法用于识别长Covid症状聚类及其功能相关性。采用多变量logistic回归对长期发病和严重程度的预测因素进行评估。总体而言，240/1205名参与者（19.9%）报告长Covid。女性的长冠风险明显更高，OR为1.71 (95% CI: 1.17-2.51)，合并症患者为2.19 (95% CI: 1.56-3.08)，使用类固醇吸入器治疗Covid-19的患者为2.34 （95% CI: 1.29-4.24）。随着Covid-19感染严重程度的增加，长期感染风险增加（中重度症状：2.23 [95% CI: 1.50-3.30]，极重度症状：5.80 [95% CI: 3.48-9.66]，出现在急诊科/住院：7.22 [95% CI: 3.06-17.03]）。我们发现，在Omicron和前Omicron时期、疫苗接种状况和参与者年龄之间，长Covid的可能性没有显著差异。我们确定了两个长冠状病毒聚集群（n = 170，无症状，n = 66）。多症状群集成员与较差的功能（对工作、适度活动、情绪和精力的影响）有关。严重急性感染是多症状群集成员的强预测因子（5.72[2.04-17.58]）。单克隆抗体治疗与pauci症状集群成员密切相关（0.02[0.00-0.13]）。我们的研究表明，长冠状病毒是澳大利亚的一个重要健康负担，包括在欧米克隆时代，并确定了几个风险因素。我们发现一个亚组患者的特征是更多的症状和更差的功能预后。我们的研究结果可以为保护弱势群体的政策和长期风险评估和管理框架提供信息。五分之一的人可能在急性感染后长期感染Covid-19，各年龄组的风险相似。在我们的研究中，与早期变异相比，组粒变异的风险似乎并不低。累积的症状数量可以帮助对长期感染的患者进行分类。在问卷的设计中，我们没有涉及患者或公众。然而，在试运行后，我们通过回顾患者和公众的早期反应，修改了一些调查问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.