Long-term Prognosis at 1.5 years after Infection with Wild-type strain of SARS-CoV-2 and Alpha, Delta, as well as Omicron Variants, 2023, Agergaard et

[SNT Gatchaman]

Long-term Prognosis at 1.5 years after Infection with Wild-type strain of SARS-CoV-2 and Alpha, Delta, as well as Omicron Variants
Jane Agergaard; Jesper Damsgaard Gunst; Berit Schiøttz-Christensen; Lars Østergaard; Christian Wejse

Objectives
Knowledge is limited on how changing SARS-CoV-2 variants may translate into different characteristics and affect prognosis of patients with long COVID, especially following Omicron variants. We compared long-term prognosis of patients in a Danish Post COVID Clinic infected with wild-type strain, Alpha, Delta, or Omicron variants as well as the pre-Omicron compared to the Omicron period.

Methods
At enrollment a Post COVID symptom Questionnaire (PCQ), and standard health scores, were registered, and repeated four times until 1.5 years after infection. PCQ was the primary outcome to assess severity of long COVID, and delta PCQ to assess failure to improve.

Results
A total of 806 patients were enrolled. Patients infected with Omicron and Delta variants presented with more severe long COVID (median PCQ 43 in Delta vs 38 in wild-type, P=0.003) and health scores (EQ5D-index was 0.70 in Omicron vs 0.76 in wild-type, P=0.009 and 0.78 pre-Omicron, P=0.006). At 1.5 year after infection patients had no clinically meaningful decline in severity of long COVID, and 57% (245/429) of patients failed to improve 1.5 years after infection, with no differences between variants.

Conclusions
More than half of patients referred to a Post COVID Clinic failed to improve in long COVID severity 1.5 years after infection regardless of variants of SARS-CoV-2.


Link | PDF (International Journal of Infectious Diseases)

 

[Hutan]

Post COVID Clinic at Aarhus University Hospital (AUH)

In Denmark, patients with complex and prolonged long COVID are referred to multidisciplinary regional clinics

There are a lot of typos that make this paper rather difficult to read. e.g.

More than three years after the first COVID-19 cases, several patients suffer from post-infectious health effects called long COVID [1, 2].

A systematic review from 2022 suggested individuals may have fever symptoms following Omicron compared to infection with previous variants [9], while a meta-analysis by Du et al. found no significant differences in long COVID symptoms among different variants, except for general symptoms and sleep problems [5].

(Ref 9 says "The available data suggest that the infection with the Omicron variant results in fewer long-COVID symptoms compared to previous variants" and doesn't contain the word 'fever'."
I think the International Journal of Infectious Diseases needs to work a bit harder at its editing.

The diagnosis long COVID was based on a history of probable or confirmed SARS CoV-2 infection, with symptoms persisting at least 12 weeks from onset of COVID-19, which could not be explained by an alternative diagnosis in accordance with the WHO definition and Danish guidelines [3, 19].

first clinic visit at a median of 7 (IQR 4-11) months after infection, which were repeated online 6, 12, 24, and 48 weeks later at a median of 8 (IQR 6-12), 10 (IQR 7-14), 12 (IQR 10-16) and 18 (IQR 15-22) months after SARS-CoV-2 infection, hereafter referred to as 7, 8, 10, 12 and 18-month follow-up after infection, respectively.

 

[Hutan]

In the study cohort 69% (556/804) of patients were infected during the wild-type period, whereas 9% (73/804), 7% (59/804), and 15% (118/804) were infected in the Alpha, Delta, and Omicron periods, respectively. Patients had their first clinic visit earlier after infection in the Delta and Omicron periods (both with a median at 4 months) compared to the wild-type period, where patients attended their first clinic visit at a median 9 months after infection (P<0.001). Fewer patients were hospitalized during the acute phase in the Omicron (4%) compared to the wild-type period (12%; P=0.02). Age, sex, comorbidity level, BMI, previous depression, smoking, and alcohol intake did not differ between patients during the variant of concern periods compared to the wild-type period

Worth noting the patients with later variants were seen earlier (median 4 months). That might have affected severity ratings and recovery rates.
Also, most of the patients were infected during the 'wild-type' period (556/804).