Long-term outcomes of SARS-CoV-2 variants and other respiratory infections: evidence from the Virus Watch prospective cohort in England

Sarah Beale*, Alexei Yavlinsky, Wing L.E. Fong, Vincent G. Nguyen, Jana Kovar, Theo Vos, Sarah Wulf Hanson, Andrew C. Hayward, Ibrahim Abubakar, Robert W. Aldridge

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

This study compared the likelihood of long-term sequelae following infection with SARS-CoV-2 variants, other acute respiratory infections (ARIs) and non-infected individuals. Participants (n=5,630) were drawn from Virus Watch, a prospective community cohort investigating SARS-CoV-2 epidemiology in England. Using logistic regression, we compared predicted probabilities of developing long-term symptoms (>2 months) during different variant dominance periods according to infection status (SARS-CoV-2, other ARI, or no infection), adjusting for confounding by demographic and clinical factors and vaccination status. SARS-CoV-2 infection during early variant periods up to Omicron BA.1 was associated with greater probability of long-term sequalae (adjusted predicted probability (PP) range 0.27, 95% CI = 0.22-0.33 to 0.34, 95% CI = 0.25-0.43) compared with later Omicron sub-variants (PP range 0.11, 95% CI 0.08-0.15 to 0.14, 95% CI 0.10-0.18). While differences between SARS-CoV-2 and other ARIs (PP range 0.08, 95% CI 0.04-0.11 to 0.23, 95% CI 0.18-0.28) varied by period, all post-infection estimates substantially exceeded those for non-infected participants (PP range 0.01, 95% CI 0.00, 0.02 to 0.03, 95% CI 0.01-0.06). Variant was an important predictor of SARS-CoV-2 post-infection sequalae, with recent Omicron sub-variants demonstrating similar probabilities to other contemporaneous ARIs. Further aetiological investigation including between-pathogen comparison is recommended.

Original languageEnglish
Article numbere77
JournalEpidemiology and Infection
Volume152
DOIs
Publication statusPublished - 10 May 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 The Author(s).

Keywords

  • COVID-19
  • Long Covid
  • SARS-CoV-2
  • post-viral syndromes

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