Improvement of Long COVID symptoms over one year

Carlos R Oliveira; Leonard A Jason; Derya Unutmaz; Lucinda Bateman; Suzanne D Vernon

doi:10.3389/fmed.2022.1065620

Improvement of Long COVID symptoms over one year

Front Med (Lausanne). 2023 Jan 9:9:1065620. doi: 10.3389/fmed.2022.1065620. eCollection 2022.

Authors

Carlos R Oliveira^{1

2}, Leonard A Jason³, Derya Unutmaz⁴, Lucinda Bateman⁵, Suzanne D Vernon⁵

Affiliations

¹ Section of Infectious Diseases and Global Health, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States.
² Section of Health Informatics, Department of Biostatistics, Yale University School of Public Health, New Haven, CT, United States.
³ Center for Community Research, DePaul University, Chicago, IL, United States.
⁴ The Jackson Laboratory for Genomic Medicine, University of Connecticut School of Medicine, Farmington, CT, United States.
⁵ Bateman Horne Center, Salt Lake City, UT, United States.

Abstract

Importance: Early and accurate diagnosis and treatment of Long COVID, clinically known as post-acute sequelae of COVID-19 (PASC), may mitigate progression to chronic diseases such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Our objective was to determine the utility of the DePaul Symptom Questionnaire (DSQ) to assess the frequency and severity of common symptoms of ME/CFS, to diagnose and monitor symptoms in patients with PASC.

Methods: This prospective, observational cohort study enrolled 185 people that included 34 patients with PASC that had positive COVID-19 test and persistent symptoms of >3 months and 151 patients diagnosed with ME/CFS. PASC patients were followed over 1 year and responded to the DSQ at baseline and 12 months. ME/CFS patients responded to the DSQ at baseline and 1 year later. Changes in symptoms over time were analyzed using a fixed-effects model to compute difference-in-differences estimates between baseline and 1-year follow-up assessments.

Participants: Patients were defined as having PASC if they had a previous positive COVID-19 test, were experiencing symptoms of fatigue, post-exertional malaise, or other unwellness for at least 3 months, were not hospitalized for COVID-19, had no documented major medical or psychiatric diseases prior to COVID-19, and had no other active and untreated disease processes that could explain their symptoms. PASC patients were recruited in 2021. ME/CFS patients were recruited in 2017.

Results: At baseline, patients with PASC had similar symptom severity and frequency as patients with ME/CFS and satisfied ME/CFS diagnostic criteria. ME/CFS patients experienced significantly more severe unrefreshing sleep and flu-like symptoms. Five symptoms improved significantly over the course of 1 year for PASC patients including fatigue, post-exertional malaise, brain fog, irritable bowel symptoms and feeling unsteady. In contrast, there were no significant symptom improvements for ME/CFS patients.

Conclusion and relevance: There were considerable similarities between patients with PASC and ME/CFS at baseline. However, symptoms improved for PASC patients over the course of a year but not for ME/CFS patients. PASC patients with significant symptom improvement no longer met ME/CFS clinical diagnostic criteria. These findings indicate that the DSQ can be used to reliably assess and monitor PASC symptoms.

Keywords: Long COVID; brain fog; fatigue; myalgic encephalomyelitis; post-acute COVID-19 syndrome; post-exertional malaise; unrefreshing sleep.

Abstract

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