Publication date: Feb 01, 2025
After surviving Coronavirus Disease 2019 (COVID-19), some people develop symptoms known as post-acute sequelae of COVID-19 (PASC). PASC is an emerging phenomenon yet to be fully understood, and identifying risk factors has been challenging. This study investigated the association between the number of COVID-19 episodes and the incidence of PASC among essential workers. We analyzed data from 2511 essential workers, mainly first responders, with confirmed polymerase chain reaction, antibody, or antigen-positive test results for SARS-CoV-2 infection from March 2020 to February 2024. Data were collected through in-person questionnaires and surveys sent via text and email, internal medical records, follow-up calls, and external medical records. Participants who reported continuation or the development of new symptoms three months after the initial SARS-CoV-2 infection, with symptoms lasting for at least two months, were categorized as having PASC, while those without any COVID-19 or whose symptoms resolved were classified as non-PASC. PASC was common in this cohort so we used a Poisson regression model to compute multivariable-adjusted Relative Risk (RR) for the association between risk of PASC and SARS-CoV-2 re-infection, severity, and vaccination status at first infection. A total of 475 (prevalence = 18. 9%, [95% confidence interval] = [17. 4-20. 5]) PASC patients were identified. The mean (standard deviation (SD)) age of participants who experienced PASC (54. 8 (7. 2) years) was similar to those who did not (54. 2 (7. 4) years). There were 403 (16. 1% [14. 6-17. 5]) participants who experienced multiple instances of COVID-19. After adjusting for relevant demographic, lifestyle, and clinical variables, we found a significant association between the risk of experiencing PASC and multiple SARS-COV-2 infections (RR = 1. 41 [1. 14-1. 74]), severe COVID-19 (RR = 3. 17 [2. 41-4. 16]), and being unvaccinated at first infection (RR = 3. 29 [2. 46-4. 41]). Although the pathogenetic mechanism for PASC remains unclear, identifying risk factors such as lack of vaccination or re-infection can assist in better understanding and managing the condition. National Institute on Aging (NIH/NIA R01 AG049953) and Centers for Disease Control and Prevention (CDC/NIOSH U01 OH011864) and (CDC/NIOSH U01 OH012275).
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| Concepts | Keywords |
|---|---|
| Coronavirus | COVID-19 |
| Post-COVID-19 | |
| February | Reinfection |
| Vaccination | SARS-COV-2 |
| Severity | |
| Vaccination |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | re-infection |
| disease | MESH | post-acute sequelae of COVID-19 |
| disease | MESH | Coronavirus Disease 2019 |
| pathway | REACTOME | SARS-CoV-2 Infection |
| disease | MESH | infection |
| disease | MESH | lifestyle |
| drug | DRUGBANK | Tropicamide |
| disease | MESH | sequelae |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | viral load |
| disease | MESH | causes |
| disease | IDO | history |
| disease | MESH | chest pain |
| disease | MESH | cognitive dysfunction |
| disease | MESH | brain fog |
| disease | MESH | Altered Taste |
| disease | MESH | Dyspnea |
| disease | MESH | Sore throat |
| disease | MESH | Back pain |
| disease | MESH | Metallic taste |
| drug | DRUGBANK | Isoxaflutole |
| disease | MESH | Vertigo |
| disease | MESH | Tinnitus |
| disease | MESH | Migraine |
| drug | DRUGBANK | Oxygen |
| disease | MESH | Asthma |
| pathway | KEGG | Asthma |
| disease | MESH | Weight loss |
| disease | MESH | GERD |
| disease | MESH | Numbness |
| disease | MESH | Nerve pain |
| disease | MESH | Anxiety |
| disease | MESH | Depression |
| disease | MESH | emergency |
| disease | IDO | symptom |
| drug | DRUGBANK | Sulpiride |
| disease | MESH | COVID-19 Reinfection |