Prevalence and Risk Factors of Post-Acute Sequela of COVID-19 in Adults with Systemic Autoimmune Rheumatic Diseases, 2024, Teles et al.

Prevalence and Risk Factors of Post-Acute Sequela of COVID-19 in Adults with Systemic Autoimmune Rheumatic Diseases
Mayan S. Teles; Janetta Brundage; Teresa Po-Yu Chiang; Jennifer L. Alejo; Nicolas Henriquez; Rachel Wallwork; Lisa Christopher Stine; Allan Massie; Dorry L. Segev; Caoilfhionn M. Connolly; Julie J. Paik; William A. Werbel

OBJECTIVES
Incidence and manifestations of post-acute sequelae of COVID-19 (PASC) are poorly defined among immunosuppressed populations. We reported, phenotyped, and assessed risk factors for PASC in adults with systemic autoimmune diseases.

METHODS
Persons ≥18 years with systemic autoimmune diseases were recruited into a national, prospective cohort of SARS-CoV-2 vaccination between 12/2020-4/2021. Serial surveys assessed vaccination status, SARS-CoV-2 infection incidence, and disease flares. Participants reporting SARS-CoV-2 infection received a questionnaire assessing symptom duration, severity, and quality of life (QoL) impact; PASC was defined as ≥1 symptom persisting for >12 weeks. PASC syndromes were mapped via overlapping symptom domains. Characteristics were compared between participants who did versus did not report PASC.

RESULTS
Among 1615 participants, 590 (36.5%) reported SARS-CoV-2 infection and were sent PASC surveys, 299 (50.7%) of whom responded >12 weeks following reported infection. Respondents were 1.62% female, 90.2% white, median (IQR) age 48(40-60) years with median (IQR) 3 (2-3) vaccine doses at time of first infection. Common diagnoses included inflammatory arthritis (38.5%) and inflammatory bowel disease (14.4%). 89/299 (29.8%) reported PASC, with the most reported symptom domain being neurological/psychological (83.1%); 84% reported an impact on QoL. Participants with PASC reported lower number of preceding vaccines (median [IQR] 2[2-3] versus 3[2-3]; p<0.001) and more reinfections (16.9% versus 5.7%; p=0.004).

CONCLUSIONS
29.8% of persons with systemic autoimmune disease in a large real-world cohort reported PASC, often affecting QoL. Preceding vaccination may reduce PASC, whereas multiple infections may increase risk, supporting ongoing booster vaccine campaigns and efforts to limit breakthrough infections.


Link | PDF (The Journal of Rheumatology) [Open Access]

 

Too bad the current strategy has minimized the former and maximized the latter, on the absurd notion that it's not just equally good, but that more infections are actually better, since they keep the immunity up. Or whatever.