Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries
Background: The World Health Organisation (WHO) has identified a range of symptomatic manifestations to aid in the clinical diagnosis of post-COVID conditions, herein referred to as post-acute COVID-19 symptoms. We conducted an international network cohort study to estimate the burden of these sympt...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universitat Autònoma de Barcelona |
| Repositorio: | Dipòsit Digital de Documents de la UAB |
| Idioma: | inglés |
| OAI Identifier: | oai:ddd.uab.cat:311094 |
| Acceso en línea: | https://ddd.uab.cat/record/311094 https://dx.doi.org/urn:doi:10.1016/j.eclinm.2024.102903 |
| Access Level: | acceso abierto |
| Palabra clave: | Epidemiology Incidence of post-acute COVID-19 symptoms International cohort study Post-acute COVID-19 condition Real world data |
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oai:ddd.uab.cat:311094 |
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España |
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| dc.title.none.fl_str_mv |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries an international retrospective cohort study using routinely-collected data |
| title |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries |
| spellingShingle |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries Xie, Junqing|||0000-0002-0040-0042 Epidemiology Incidence of post-acute COVID-19 symptoms International cohort study Post-acute COVID-19 condition Real world data |
| title_short |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries |
| title_full |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries |
| title_fullStr |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries |
| title_full_unstemmed |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries |
| title_sort |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countries |
| dc.creator.none.fl_str_mv |
Xie, Junqing|||0000-0002-0040-0042 López-Güell, Kim|||0000-0002-8462-8668 Dedman, Daniel Duarte Salles, Talita|||0000-0002-8274-0357 Kolde, Raivo López-Blasco, Raúl Martínez, Álvaro Mercier, Gregoire|||0000-0001-5531-4515 Abellan, Alicia|||0000-0001-6552-6060 Arinze, Johnmary Tochukwu Cuccu, Zara Delmestri, Antonella|||0000-0003-0388-3403 Delseny, Dominique Khalid, Sara|||0000-0002-2845-5731 Kim, Chungsoo|||0000-0003-1802-1777 Kim, Ji-woo Kostka, Kristin|||0000-0003-2595-8736 Loste, Cora Mateu, Lourdes|||0000-0001-7223-7611 Mayer, Miguel Angel|||0000-0003-0362-6298 Meléndez-Cardiel, Jaime Mercadé-Besora, Núria Mosseveld, Mees|||0000-0001-9301-8565 Nishimura, Akihito Nordeng, Hedvig M. E. Oyinlola, Jessie O. Pérez-Crespo, Laura|||0000-0002-8288-5716 Pineda-Moncusí, Marta|||0000-0003-0567-0137 Ramírez-Anguita, Juan Manuel|||0000-0002-8509-0927 Trinh, Nhung T.H. Uusküla, Anneli Valdivieso, Bernardo Burkard, Theresa|||0000-0003-1313-4473 Burn, Edward|||0000-0002-9286-1128 Català, Martí|||0000-0003-3308-9905 Prieto-Alhambra, Daniel|||0000-0002-3950-6346 Paredes, Roger|||0000-0002-6553-691X Jödicke, Annika|||0000-0002-0000-0110 |
| author |
Xie, Junqing|||0000-0002-0040-0042 |
| author_facet |
Xie, Junqing|||0000-0002-0040-0042 López-Güell, Kim|||0000-0002-8462-8668 Dedman, Daniel Duarte Salles, Talita|||0000-0002-8274-0357 Kolde, Raivo López-Blasco, Raúl Martínez, Álvaro Mercier, Gregoire|||0000-0001-5531-4515 Abellan, Alicia|||0000-0001-6552-6060 Arinze, Johnmary Tochukwu Cuccu, Zara Delmestri, Antonella|||0000-0003-0388-3403 Delseny, Dominique Khalid, Sara|||0000-0002-2845-5731 Kim, Chungsoo|||0000-0003-1802-1777 Kim, Ji-woo Kostka, Kristin|||0000-0003-2595-8736 Loste, Cora Mateu, Lourdes|||0000-0001-7223-7611 Mayer, Miguel Angel|||0000-0003-0362-6298 Meléndez-Cardiel, Jaime Mercadé-Besora, Núria Mosseveld, Mees|||0000-0001-9301-8565 Nishimura, Akihito Nordeng, Hedvig M. E. Oyinlola, Jessie O. Pérez-Crespo, Laura|||0000-0002-8288-5716 Pineda-Moncusí, Marta|||0000-0003-0567-0137 Ramírez-Anguita, Juan Manuel|||0000-0002-8509-0927 Trinh, Nhung T.H. Uusküla, Anneli Valdivieso, Bernardo Burkard, Theresa|||0000-0003-1313-4473 Burn, Edward|||0000-0002-9286-1128 Català, Martí|||0000-0003-3308-9905 Prieto-Alhambra, Daniel|||0000-0002-3950-6346 Paredes, Roger|||0000-0002-6553-691X Jödicke, Annika|||0000-0002-0000-0110 |
| author_role |
author |
| author2 |
López-Güell, Kim|||0000-0002-8462-8668 Dedman, Daniel Duarte Salles, Talita|||0000-0002-8274-0357 Kolde, Raivo López-Blasco, Raúl Martínez, Álvaro Mercier, Gregoire|||0000-0001-5531-4515 Abellan, Alicia|||0000-0001-6552-6060 Arinze, Johnmary Tochukwu Cuccu, Zara Delmestri, Antonella|||0000-0003-0388-3403 Delseny, Dominique Khalid, Sara|||0000-0002-2845-5731 Kim, Chungsoo|||0000-0003-1802-1777 Kim, Ji-woo Kostka, Kristin|||0000-0003-2595-8736 Loste, Cora Mateu, Lourdes|||0000-0001-7223-7611 Mayer, Miguel Angel|||0000-0003-0362-6298 Meléndez-Cardiel, Jaime Mercadé-Besora, Núria Mosseveld, Mees|||0000-0001-9301-8565 Nishimura, Akihito Nordeng, Hedvig M. E. Oyinlola, Jessie O. Pérez-Crespo, Laura|||0000-0002-8288-5716 Pineda-Moncusí, Marta|||0000-0003-0567-0137 Ramírez-Anguita, Juan Manuel|||0000-0002-8509-0927 Trinh, Nhung T.H. Uusküla, Anneli Valdivieso, Bernardo Burkard, Theresa|||0000-0003-1313-4473 Burn, Edward|||0000-0002-9286-1128 Català, Martí|||0000-0003-3308-9905 Prieto-Alhambra, Daniel|||0000-0002-3950-6346 Paredes, Roger|||0000-0002-6553-691X Jödicke, Annika|||0000-0002-0000-0110 |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Universitat Autònoma de Barcelona |
| dc.subject.none.fl_str_mv |
Epidemiology Incidence of post-acute COVID-19 symptoms International cohort study Post-acute COVID-19 condition Real world data |
| topic |
Epidemiology Incidence of post-acute COVID-19 symptoms International cohort study Post-acute COVID-19 condition Real world data |
| description |
Background: The World Health Organisation (WHO) has identified a range of symptomatic manifestations to aid in the clinical diagnosis of post-COVID conditions, herein referred to as post-acute COVID-19 symptoms. We conducted an international network cohort study to estimate the burden of these symptoms in North American, European, and Asian populations. Methods: A federated analysis was conducted including 10 databases from the United Kingdom, Netherlands, Norway, Estonia, Spain, France, South Korea, and the United States, between September 1st 2020 and latest data availability (which varied from December 31st 2021 to February 28th 2023), covering primary and secondary care, nationwide registries, and claims data, all mapped to the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). We defined two cohorts for the main analyses: a SARS-CoV-2 infection cohort [positive polymerase chain reaction (PCR) or rapid lateral flow test (LFT) result or clinical COVID-19 diagnosis] and a general population cohort. Individuals with less than 365 days of prior history or 120 days of follow-up were excluded. We estimated incidence rates (IRs) of the 25 WHO-proposed post-acute COVID-19 symptoms, considering symptoms that occurred ≥90 and ≤365 days after index date, excluding individuals with the respective symptoms 180 days prior to the index event. Stratified analyses were conducted by age and sex. Incidence rate ratios (IRRs) were calculated comparing rates in the infected cohort versus the general population. Results from the different databases were combined using random-effects meta-analyses. Findings: 3,019,408 individuals were included in the infection cohort. 1,585,160 of them were female and 1,434,248 of them male. 929,351,505 individuals were included in the general population group. 461,195,036 of them were female and 466,022,004 of them male. The 1-year IR of any post-acute COVID-19 symptom in the COVID-19 infection cohort varied significantly across databases, from 4.4 (95% CI 3.8-5.1) per 100 person-years to 103.9 (95% CI 103.2-104.7). The five most common symptoms were joint pain (from 1.6 (95% CI 1.3-1.9) to 14.3 (95% CI 14.1-14.6)), abdominal pain (from 0.3 (95% CI 0.1-0.5) to 9.9 (95% CI 9.7-10.1)), gastrointestinal issues (from 0.6 (95% CI 0.4-0.9) to 13.3 (95% CI 13.1-13.6)), cough (from 0.3 (95% CI 0.2-0.5) to 9.1 (95% CI 8.9-9.3)), and anxiety (from 0.8 (95% CI 0.6-1.2) to 11.4 (95% CI 11.2-11.6)); whereas muscle spasms (from 0.01 (95% CI 0.008-0.2) to 1.7 (95% CI 1.6-1.8)), pins and needles (from 0.05 (95% CI 0.03-0.0.9) to 1.5 (95% CI 1.4-1.6)), memory issues (from 0.03 (95% CI 0.02-0.06) to 0.8 (95% CI 0.7-0.8)), cognitive dysfunction (from 0.007 (95% CI 0.004-0.01) to 0.6 (95% CI 0.4-0.8)), and altered smell and/or taste (from 0.04 (95% CI 0.03-0.04) to 0.7 (95% CI 0.6-0.8)) were least common. Incidence rates of any post-acute COVID-19 symptoms generally increased with age, with certain symptoms peaking in middle-aged adults (anxiety, depressive disorders, headache, altered smell and taste) and others in pre-school children (gastrointestinal issues and cough). Females had higher incidence rates for most symptoms. Based on the random-effects model, the infected cohort had a higher incidence of any post-acute COVID-19 symptom than the general population, with a meta-analytic incidence rate ratio (meta-IRR) of 1.4 (1-2). A similar pattern was seen for all individual symptoms. The highest meta-IRRs were depressive disorder, 2.6 (1.7-3.9); anxiety, 2.3 (1.4-3.8); allergy, 2.1 (1.7-2.8) and sleep disorders, 2.1 (1.5-2.6). The meta-IRR for altered smell and/or taste was 1.9 (1.3-2.8). Interpretation: Post-acute COVID-19 symptoms, as listed by the WHO, were commonly observed following COVID-19 infection. However, even after standardising research methods, there was significant heterogeneity in the incidence rates from different healthcare settings and geographical locations. This is the first international study of the epidemiology of post-acute COVID-19 symptoms using the WHO-listed symptoms. Its findings contibute to understand the epidemiology of this condition from a multinational approach. Limitations of this study include the lack of consensus of the post-acute COVID-19 definition, as well as the difficulty to capture the impact on daily life of the post-acute COVID-19 symptoms in the available datasets. Funding: This work has been funded by the European Health Data Evidence Network (EHDEN) through an Evidence Generation Fund Grant and by the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre (BRC). |
| publishDate |
2024 |
| dc.date.none.fl_str_mv |
2 2024-01-01 2024 2024-01-01 |
| dc.type.none.fl_str_mv |
Article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
https://ddd.uab.cat/record/311094 https://dx.doi.org/urn:doi:10.1016/j.eclinm.2024.102903 |
| url |
https://ddd.uab.cat/record/311094 https://dx.doi.org/urn:doi:10.1016/j.eclinm.2024.102903 |
| dc.language.none.fl_str_mv |
Inglés eng |
| language_invalid_str_mv |
Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by/4.0/ |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by/4.0/ |
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openAccess |
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application/pdf |
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reponame:Dipòsit Digital de Documents de la UAB instname:Universitat Autònoma de Barcelona |
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Universitat Autònoma de Barcelona |
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Dipòsit Digital de Documents de la UAB |
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Dipòsit Digital de Documents de la UAB |
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1869412575539625984 |
| spelling |
Incidence of post-acute COVID-19 symptoms across healthcare settings in seven countriesan international retrospective cohort study using routinely-collected dataXie, Junqing|||0000-0002-0040-0042López-Güell, Kim|||0000-0002-8462-8668Dedman, DanielDuarte Salles, Talita|||0000-0002-8274-0357Kolde, RaivoLópez-Blasco, RaúlMartínez, ÁlvaroMercier, Gregoire|||0000-0001-5531-4515Abellan, Alicia|||0000-0001-6552-6060Arinze, Johnmary TochukwuCuccu, ZaraDelmestri, Antonella|||0000-0003-0388-3403Delseny, DominiqueKhalid, Sara|||0000-0002-2845-5731Kim, Chungsoo|||0000-0003-1802-1777Kim, Ji-wooKostka, Kristin|||0000-0003-2595-8736Loste, CoraMateu, Lourdes|||0000-0001-7223-7611Mayer, Miguel Angel|||0000-0003-0362-6298Meléndez-Cardiel, JaimeMercadé-Besora, NúriaMosseveld, Mees|||0000-0001-9301-8565Nishimura, AkihitoNordeng, Hedvig M. E.Oyinlola, Jessie O.Pérez-Crespo, Laura|||0000-0002-8288-5716Pineda-Moncusí, Marta|||0000-0003-0567-0137Ramírez-Anguita, Juan Manuel|||0000-0002-8509-0927Trinh, Nhung T.H.Uusküla, AnneliValdivieso, BernardoBurkard, Theresa|||0000-0003-1313-4473Burn, Edward|||0000-0002-9286-1128Català, Martí|||0000-0003-3308-9905Prieto-Alhambra, Daniel|||0000-0002-3950-6346Paredes, Roger|||0000-0002-6553-691XJödicke, Annika|||0000-0002-0000-0110EpidemiologyIncidence of post-acute COVID-19 symptomsInternational cohort studyPost-acute COVID-19 conditionReal world dataBackground: The World Health Organisation (WHO) has identified a range of symptomatic manifestations to aid in the clinical diagnosis of post-COVID conditions, herein referred to as post-acute COVID-19 symptoms. We conducted an international network cohort study to estimate the burden of these symptoms in North American, European, and Asian populations. Methods: A federated analysis was conducted including 10 databases from the United Kingdom, Netherlands, Norway, Estonia, Spain, France, South Korea, and the United States, between September 1st 2020 and latest data availability (which varied from December 31st 2021 to February 28th 2023), covering primary and secondary care, nationwide registries, and claims data, all mapped to the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). We defined two cohorts for the main analyses: a SARS-CoV-2 infection cohort [positive polymerase chain reaction (PCR) or rapid lateral flow test (LFT) result or clinical COVID-19 diagnosis] and a general population cohort. Individuals with less than 365 days of prior history or 120 days of follow-up were excluded. We estimated incidence rates (IRs) of the 25 WHO-proposed post-acute COVID-19 symptoms, considering symptoms that occurred ≥90 and ≤365 days after index date, excluding individuals with the respective symptoms 180 days prior to the index event. Stratified analyses were conducted by age and sex. Incidence rate ratios (IRRs) were calculated comparing rates in the infected cohort versus the general population. Results from the different databases were combined using random-effects meta-analyses. Findings: 3,019,408 individuals were included in the infection cohort. 1,585,160 of them were female and 1,434,248 of them male. 929,351,505 individuals were included in the general population group. 461,195,036 of them were female and 466,022,004 of them male. The 1-year IR of any post-acute COVID-19 symptom in the COVID-19 infection cohort varied significantly across databases, from 4.4 (95% CI 3.8-5.1) per 100 person-years to 103.9 (95% CI 103.2-104.7). The five most common symptoms were joint pain (from 1.6 (95% CI 1.3-1.9) to 14.3 (95% CI 14.1-14.6)), abdominal pain (from 0.3 (95% CI 0.1-0.5) to 9.9 (95% CI 9.7-10.1)), gastrointestinal issues (from 0.6 (95% CI 0.4-0.9) to 13.3 (95% CI 13.1-13.6)), cough (from 0.3 (95% CI 0.2-0.5) to 9.1 (95% CI 8.9-9.3)), and anxiety (from 0.8 (95% CI 0.6-1.2) to 11.4 (95% CI 11.2-11.6)); whereas muscle spasms (from 0.01 (95% CI 0.008-0.2) to 1.7 (95% CI 1.6-1.8)), pins and needles (from 0.05 (95% CI 0.03-0.0.9) to 1.5 (95% CI 1.4-1.6)), memory issues (from 0.03 (95% CI 0.02-0.06) to 0.8 (95% CI 0.7-0.8)), cognitive dysfunction (from 0.007 (95% CI 0.004-0.01) to 0.6 (95% CI 0.4-0.8)), and altered smell and/or taste (from 0.04 (95% CI 0.03-0.04) to 0.7 (95% CI 0.6-0.8)) were least common. Incidence rates of any post-acute COVID-19 symptoms generally increased with age, with certain symptoms peaking in middle-aged adults (anxiety, depressive disorders, headache, altered smell and taste) and others in pre-school children (gastrointestinal issues and cough). Females had higher incidence rates for most symptoms. Based on the random-effects model, the infected cohort had a higher incidence of any post-acute COVID-19 symptom than the general population, with a meta-analytic incidence rate ratio (meta-IRR) of 1.4 (1-2). A similar pattern was seen for all individual symptoms. The highest meta-IRRs were depressive disorder, 2.6 (1.7-3.9); anxiety, 2.3 (1.4-3.8); allergy, 2.1 (1.7-2.8) and sleep disorders, 2.1 (1.5-2.6). The meta-IRR for altered smell and/or taste was 1.9 (1.3-2.8). Interpretation: Post-acute COVID-19 symptoms, as listed by the WHO, were commonly observed following COVID-19 infection. However, even after standardising research methods, there was significant heterogeneity in the incidence rates from different healthcare settings and geographical locations. This is the first international study of the epidemiology of post-acute COVID-19 symptoms using the WHO-listed symptoms. Its findings contibute to understand the epidemiology of this condition from a multinational approach. Limitations of this study include the lack of consensus of the post-acute COVID-19 definition, as well as the difficulty to capture the impact on daily life of the post-acute COVID-19 symptoms in the available datasets. Funding: This work has been funded by the European Health Data Evidence Network (EHDEN) through an Evidence Generation Fund Grant and by the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre (BRC).Universitat Autònoma de Barcelona 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/311094https://dx.doi.org/urn:doi:10.1016/j.eclinm.2024.102903reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3110942026-06-06T12:50:31Z |
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15,812429 |