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Burdens of post-acute sequelae of COVID-19 by severity of acute infection, demographics and health status, 2021, Xie et al

Discussion in 'Epidemics (including Covid-19)' started by Andy, Nov 15, 2021.

  1. Andy

    Andy Committee Member (& Outreach when energy allows)

    Hampshire, UK

    The Post-Acute Sequelae of SARS-CoV-2 infection (PASC) have been characterized; however, the burden of PASC remains unknown. Here we used the healthcare databases of the US Department of Veterans Affairs to build a cohort of 181,384 people with COVID-19 and 4,397,509 non-infected controls and estimated that burden of PASC—defined as the presence of at least one sequela in excess of non-infected controls—was 73.43 (72.10, 74.72) per 1000 persons at 6 months. Burdens of individual sequelae varied by demographic groups (age, race, and sex) but were consistently higher in people with poorer baseline health and in those with more severe acute infection. In sum, the burden of PASC is substantial; PASC is non-monolithic with sequelae that are differentially expressed in various population groups. Collectively, our results may be useful in informing health systems capacity planning and care strategies of people with PASC.

    Open access, https://www.nature.com/articles/s41467-021-26513-3
  2. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

    I suspect not all sequelae will prove to be equal. Some such as long term lung damage will be related to the severity of the initial infection, but others such as those experienced by patients who meet ME/CFS diagnostic criteria represent a distinct disease process or processes that, though triggered by the initial viral infection, has its own distinct momentum.
    Mithriel, alktipping and CRG like this.
  3. CRG

    CRG Senior Member (Voting Rights)

    There seem to be only 5 sequelae recorded that map to main ME/CFS symptoms - fatigue, muscle weakness, joint pain, memory problems and sleep disorder. Of these only sleep disorder does not show marked age related significance - Table 3. And interestingly all five present disproportionately as a burden for males - Table 4, 3rd column - a complete reversal of what one would expect in an ME/CFS cohort.

    At 73.43 per 1000 the sequelae present cohort is 20 times the highest rate currently talked about for ME/CFS prevalence (250k per UK population) and with so many non ME/CFS specific sequelae included it seems probable that any post COVID propensity for ME/CFS is going to be drowned out. But the high prevalence of the five sequelae that are mappable across to ME/CFS perhaps shows how non specific they can be in post viral syndromes.
  4. hibiscuswahine

    hibiscuswahine Senior Member (Voting Rights)

    Peter Trewhitt, Anna H and Trish like this.

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