Predictive characteristics of prolonged symptoms and seroconversion in ambulatory patients recovering from SARS-CoV-2 infection

  • Vamsi P. Guntur National Jewish Health
  • Brian Modena
  • Claudia Onofrei National Jewish Health
  • Shu-Yi Liao National Jewish Health
  • Pearlanne Zelarney National Jewish Health
  • Jared Eddy National Jewish Health
  • Rebecca Keith National Jewish Health
  • Rachel DeCosta National Jewish Health
  • Irina Petrache National Jewish Health
  • Nir Goldstein National Jewish Health

Abstract

Introduction: As an increasing number of patients present for ambulatory care following acute COVID-19, we set out to characterize and identify clinical predictors of prolonged symptoms and antibody seroconversion. We hypothesized that patients who present with a high symptom burden are more likely have prolonged post-acute sequelae of COVID-19 (PASC). Methods: All adults with confirmed SARS-CoV-2 infection evaluated at a single ambulatory center between April and September 2020 were studied retrospectively using a logit model and ANOVA; the importance of variables associated with prolonged symptoms and seroconversion was determined using machine learning methodology. Results: The most common initial symptoms of 276 subjects were fatigue, dyspnea, cough, fever, and myalgia, with ~30% experiencing all five. Those with prolonged sequelae (>4 weeks) reported higher initial symptom burden compared to those without PASC (mean 8.2 vs. 3.3 symptoms, p<0.0001). Anosmia (odds ratio, OR 23.0), myalgia (OR 12.8), and dyspnea (OR 10.8) had highest predictive values for prolonged sequelae. Neither lung function, nor pre-existing lung disease correlated with PASC pulmonary symptoms (p=0.17, p=0.5, respectively). Natural post-COVID-19 seroconversion rate was 78%, with male gender having higher and corticosteroid treatment and elevated creatinine having lower likelihood of seroconversion. Conclusion: Ambulatory PASC patients display a broad range of symptoms. A high initial symptom burden correlates with prolonged sequelae. In unvaccinated individuals, antibody seroconversion may be influenced by gender, corticosteroid use, and renal function.

Downloads

Download data is not yet available.
Published
2022-07-22
How to Cite
Guntur, V., Modena, B., Onofrei, C., Liao, S.-Y., Zelarney, P., Eddy, J., Keith, R., DeCosta, R., Petrache, I., & Goldstein, N. (2022). Predictive characteristics of prolonged symptoms and seroconversion in ambulatory patients recovering from SARS-CoV-2 infection. The Southwest Respiratory and Critical Care Chronicles, 10(44), 1-9. https://doi.org/10.12746/swrccc.v10i44.1035