Association between SARS-CoV-2 infection and select symptoms and conditions 31 to 150 days after testing among children and adults.

Publication date: Feb 10, 2024

An increasing number of studies have described new and persistent symptoms and conditions as potential post-acute sequelae of SARS-CoV-2 infection (PASC). However, it remains unclear whether certain symptoms or conditions occur more frequently among persons with SARS-CoV-2 infection compared with those never infected with SARS-CoV-2. We compared the occurrence of specific COVID-associated symptoms and conditions as potential PASC 31- to 150-day following a SARS-CoV-2 test among adults and children with positive and negative test results. We conducted a retrospective cohort study using electronic health record (EHR) data from 43 PCORnet sites participating in a national COVID-19 surveillance program. This study included 3,091,580 adults (316,249 SARS-CoV-2 positive; 2,775,331 negative) and 675,643 children (62,131 positive; 613,512 negative) who had a SARS-CoV-2 laboratory test during March 1, 2020-May 31, 2021 documented in their EHR. We used logistic regression to calculate the odds of having a symptom and Cox models to calculate the risk of having a newly diagnosed condition associated with a SARS-CoV-2 positive test. After adjustment for baseline covariates, hospitalized adults and children with a positive test had increased odds of being diagnosed with ≥ 1 symptom (adults: adjusted odds ratio[aOR], 1. 17[95% CI, 1. 11-1. 23]; children: aOR, 1. 18[95% CI, 1. 08-1. 28]) or shortness of breath (adults: aOR, 1. 50[95% CI, 1. 38-1. 63]; children: aOR, 1. 40[95% CI, 1. 15-1. 70]) 31-150 days following a SARS-CoV-2 test compared with hospitalized individuals with a negative test. Hospitalized adults with a positive test also had increased odds of being diagnosed with ≥ 3 symptoms or fatigue compared with those testing negative. The risks of being newly diagnosed with type 1 or type 2 diabetes (adjusted hazard ratio[aHR], 1. 25[95% CI, 1. 17-1. 33]), hematologic disorders (aHR, 1. 19[95% CI, 1. 11-1. 28]), or respiratory disease (aHR, 1. 44[95% CI, 1. 30-1. 60]) were higher among hospitalized adults with a positive test compared with those with a negative test. Non-hospitalized adults with a positive test also had higher odds or increased risk of being diagnosed with certain symptoms or conditions. Patients with SARS-CoV-2 infection, especially those who were hospitalized, were at higher risk of being diagnosed with certain symptoms and conditions after acute infection.

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Concepts Keywords
150days COVID-19 pandemic
Diabetes Electronic health record
Hematologic Long-COVID
Surveillance SARS-CoV-2


Type Source Name
disease MESH SARS-CoV-2 infection
pathway REACTOME SARS-CoV-2 Infection
disease MESH post-acute sequelae of SARS-CoV-2 infection
disease VO laboratory test
disease IDO symptom
disease MESH type 2 diabetes
disease IDO acute infection
disease MESH Infectious Diseases
disease MESH infection
disease MESH sequelae
disease VO organ
disease VO population
disease IDO site
disease VO monthly
disease VO vaccine
disease MESH diabetes mellitus
disease MESH venous thromboembolism
disease MESH neurological disorders
disease MESH respiratory diseases
disease MESH chest pain
disease MESH abnormalities
disease MESH sleep disorders
disease MESH arthralgias
drug DRUGBANK Dexamethasone
disease MESH obesity
drug DRUGBANK Aspartame
disease MESH comorbidity
disease MESH cognitive disorders
disease MESH mood disorders
disease MESH psychosis
disease MESH suicide
disease MESH syndromes
disease MESH pulmonary embolism
disease MESH heart failure
disease MESH intracerebral hemorrhage
disease MESH infarction
disease MESH myocardial infarction
disease MESH myocarditis
disease MESH subarachnoid hemorrhage
disease MESH transient ischemic attack
disease MESH stroke
disease MESH ataxia
disease MESH dementia
disease MESH encephalitis
disease MESH parkinsonism
disease MESH seizures
disease MESH asthma
pathway KEGG Asthma
disease MESH chronic bronchitis
disease MESH chronic obstructive pulmonary disease
disease MESH interstitial lung disease
disease MESH pulmonary edema
disease MESH pulmonary hypertension
disease MESH respiratory failure
drug DRUGBANK Coenzyme M
disease VO effective
disease VO vaccination
disease VO vaccinated
disease MESH asymptomatic infections
disease MESH chronic conditions
drug DRUGBANK Adenosine
disease VO USA
disease VO Canada
disease MESH Purpura
disease VO ReCOV

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