Frontiers in Medicine (Aug 2023)
Longitudinal clinical phenotyping of post COVID condition in Mexican adults recovering from severe COVID-19: a prospective cohort study
- Isaac Núñez,
- Isaac Núñez,
- Joshua Gillard,
- Joshua Gillard,
- Joshua Gillard,
- Joshua Gillard,
- Sergio Fragoso-Saavedra,
- Sergio Fragoso-Saavedra,
- Sergio Fragoso-Saavedra,
- Dorien Feyaerts,
- León Islas-Weinstein,
- Angel A. Gallegos-Guzmán,
- Uriel Valente-García,
- Justin Meyerowitz,
- J. Daniel Kelly,
- J. Daniel Kelly,
- J. Daniel Kelly,
- Han Chen,
- Edward Ganio,
- Alexander Benkendorff,
- Jaime Flores-Gouyonnet,
- Pedro Dammann-Beltrán,
- José Francisco Heredia-González,
- Gabriela A. Rangel-Gutiérrez,
- Catherine A. Blish,
- Catherine A. Blish,
- Catherine A. Blish,
- Catherine A. Blish,
- Kari C. Nadeau,
- Kari C. Nadeau,
- Kari C. Nadeau,
- Kari C. Nadeau,
- Garry Nolan,
- Jose C. Crispín,
- Jose C. Crispín,
- David R. McIlwain,
- Brice Gaudillière,
- Sergio I. Valdés-Ferrer,
- Sergio I. Valdés-Ferrer
Affiliations
- Isaac Núñez
- Department of Medical Education, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Isaac Núñez
- Division of Postrgraduate Studies, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Joshua Gillard
- Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, Netherlands
- Joshua Gillard
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, Netherlands
- Joshua Gillard
- Center for Molecular and Biomolecular Informatics, Radboud University Medical Center, Nijmegen, Netherlands
- Joshua Gillard
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Sergio Fragoso-Saavedra
- Department of Medical Education, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Sergio Fragoso-Saavedra
- Division of Postrgraduate Studies, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Sergio Fragoso-Saavedra
- Combined Study Plan in Medicine, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Dorien Feyaerts
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
- León Islas-Weinstein
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Angel A. Gallegos-Guzmán
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Uriel Valente-García
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Justin Meyerowitz
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
- J. Daniel Kelly
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, United States
- J. Daniel Kelly
- 0Institute for Global Health Sciences, UCSF, San Francisco, CA, United States
- J. Daniel Kelly
- 1F.IProctor Foundation, UCSF, San Francisco, CA, United States
- Han Chen
- 2Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
- Edward Ganio
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Alexander Benkendorff
- 3Institute of Neuropathology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Jaime Flores-Gouyonnet
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Pedro Dammann-Beltrán
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- José Francisco Heredia-González
- Combined Study Plan in Medicine, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Gabriela A. Rangel-Gutiérrez
- Combined Study Plan in Medicine, Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Catherine A. Blish
- 2Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
- Catherine A. Blish
- 4Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Catherine A. Blish
- 5Chan Zuckerberg Biohub, San Francisco, CA, United States
- Catherine A. Blish
- 6Division of Infectious Diseases, Stanford University, Stanford, CA, United States
- Kari C. Nadeau
- 4Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Kari C. Nadeau
- 7Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, United States
- Kari C. Nadeau
- 8Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, Stanford, CA, United States
- Kari C. Nadeau
- 9Institute for Immunity, Transplantation, and Infectious Diseases, Stanford University, Stanford, CA, United States
- Garry Nolan
- 0Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
- Jose C. Crispín
- 1School of Medicine and Health Sciencies, Tecnologico de Monterrey, Mexico City, Mexico
- Jose C. Crispín
- 2Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- David R. McIlwain
- 2Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
- Brice Gaudillière
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
- Sergio I. Valdés-Ferrer
- Department of Neurology & Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Sergio I. Valdés-Ferrer
- 3Center for Biomedical Science, Feinstein Institutes for Medical Research, New York, NY, United States
- DOI
- https://doi.org/10.3389/fmed.2023.1236702
- Journal volume & issue
-
Vol. 10
Abstract
IntroductionFew studies have evaluated the presence of Post COVID-19 conditions (PCC) in people from Latin America, a region that has been heavily afflicted by the COVID-19 pandemic. In this study, we describe the frequency, co-occurrence, predictors, and duration of 23 symptoms in a cohort of Mexican patients with PCC.MethodsWe prospectively enrolled and followed adult patients hospitalized for severe COVID-19 at a tertiary care centre in Mexico City. The incidence of PCC symptoms was determined using questionnaires. Unsupervised clustering of PCC symptom co-occurrence and Kaplan–Meier analyses of symptom persistence were performed. The effect of baseline clinical characteristics was evaluated using Cox regression models and reported with hazard ratios (HR).ResultsWe found that amongst 192 patients with PCC, respiratory problems were the most prevalent and commonly co-occurred with functional activity impairment. 56% had ≥5 persistent symptoms. Symptom persistence probability at 360 days 0.78. Prior SARS-CoV-2 vaccination and infection during the Delta variant wave were associated with a shorter duration of PCC. Male sex was associated with a shorter duration of functional activity impairment and respiratory symptoms. Hypertension and diabetes were associated with a longer duration of functional impairment. Previous vaccination accelerated PCC recovery.DiscussionIn our cohort, PCC symptoms were frequent (particularly respiratory and neurocognitive ones) and persistent. Importantly, prior SARS-CoV-2 vaccination resulted in a shorter duration of PCC.
Keywords
