Preprint Increase in diagnoses associated with [PASC] before and during [pandemic]: a case-control study in the total population of Stockholm, 2024, Lindberg+

[SNT Gatchaman]

Increase in diagnoses associated with Post Acute Sequelae of COVID-19 PASC before and during the COVID-19 pandemic: a case-control study in the total population of Region Stockholm.
Pia Lindberg; Gunnar Ljunggren; Seika Lee; Iryna Kolosenko; Michael Runold; Kristina Piontkovskaya; Caroline Wachtler; Åsa M Wheelock; Axel C. Carlsson

OBJECTIVES
Post Acute Sequele of COVID-19 (PASC) is a remaining health concern after the pandemic. We aimed to investigate the prevalence of diagnoses and symptom diagnoses recorded before and during the pandemic in individuals who later received PASC.

METHODS
A case-control study was designed to investigate the prevalence of registered diagnoses in adult, non-hospitalized PASC patients (cases) 2019, 12 months before and 6 months after the PASC diagnosis compared to matched controls. Data was extracted from the Stockholm Region's data warehouse (VAL).

RESULTS
Results indicate higher diagnosis rates for men and women with PASC already in 2019 and 12 months before diagnosis; slightly decreasing 6 months after PASC. Cases showed more pre-pandemic respiratory diagnoses compared to controls. In 2019, cases had higher rates of acute upper respiratory tract infection (OR 2.47 for men, 2.22 for women), asthma (OR 1.76 (men), 1.95 (women)), and bronchitis (OR 2.15 (men), 2.71 (women)) than controls.

CONCLUSIONS
The present study showed that individuals who later developed PASC were more likely than others to show respiratory symptoms before COVID-19. Pre-existing vulnerabilities observed before the pandemic in those later diagnosed with PASC in 2021 suggest a potential link between prior conditions and PASC development.


Link | PDF (Preprint: MedRxiv) [Open Access]

 

[SNT Gatchaman]

The study cohort comprised adults aged 18 and older residing in the Stockholm Region for the entire duration of the study, spanning from January 2019 to February 2022. Individuals who relocated in or out of the region, or died during this period, were excluded. Inclusion criteria for PASC (cases) included: a post-COVID-19 diagnosis, U09.9 (ICD-10), in individuals who were not hospitalized (non-hospitalized) for their acute phase of COVID-19.

We identified 5589 cases of PASC, with 69.10% being women, aligning with existing literature on the higher prevalence of PASC among women, both in hospitalized and non-hospitalized patients

We found higher odds of asthma and depression among PASC cases compared to controls, both before and after the PASC diagnosis.

Underreporting of PASC and diagnostic challenges likely contribute to a significant number of undiagnosed cases among controls. Hence, there appears to be an underreporting of PASC, with potentially one in ten controls remaining undiagnosed as PASC cases. Initially, numerous clinicians engaged in debate regarding the classification of PASC as a syndrome, a discourse that might have adversely affected the diagnostic process for PASC.

Looking at the number of diagnoses (of those investigated) 12 months (86.48%) before and 6 months (92.18%) after the PASC diagnosis for the controls, the controls have not sought care for these diagnoses to a high extent. This would then suggest a healthy population or a population not seeking care. Or a population without care to seek - for a long time there were no [clinicians] to refer these patients to. Additionally, controls may have lingering symptoms, but they may not be severe enough or affect their quality of life and well-being enough to make them seek care.

Sweden, which didn't even have short duration lockdowns — an all too often strongly voiced explanation for LC.

So apparently there is an "epidemic" of brain fog in Sweden, some 200K by one estimate, and they are "super puzzled" as to why. There seems to be some mention of a possible link to "so-called post-Covid syndrome", or something like that. Sweden may be famous for having infected their whole population from the start, but every country followed suit anyway.