Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel studyResearch in context

Chad K. Porter; Charmagne G. Beckett; Elizabeth Cooper; Lindsey White; David Wallace; Silvia Jakubski; David Boulifard; Megan Schilling; Peifang Sun; Jan Marayag; Amethyst Marrone; Edgar O. Nunez-Hernandez; Sindhu Vangeti; Clare Miller; Yongchao Ge; Irene Ramos; Carl Goforth; Stuart C. Sealfon; Andrew G. Letizia

The Lancet Regional Health. Americas (Nov 2024)

Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel studyResearch in context

Chad K. Porter,
Charmagne G. Beckett,
Elizabeth Cooper,
Lindsey White,
David Wallace,
Silvia Jakubski,
David Boulifard,
Megan Schilling,
Peifang Sun,
Jan Marayag,
Amethyst Marrone,
Edgar O. Nunez-Hernandez,
Sindhu Vangeti,
Clare Miller,
Yongchao Ge,
Irene Ramos,
Carl Goforth,
Stuart C. Sealfon,
Andrew G. Letizia

Affiliations

Chad K. Porter: Naval Medical Research Command, Silver Spring, MD, USA; Corresponding author. Translational and Clinical Research Department, Directorate for DoD Infectious Diseases Research, Naval Medical Research Command, 503 Robert Grant Avenue, Silver Spring, MD, 20910, USA.
Charmagne G. Beckett: Naval Medical Research Command, Silver Spring, MD, USA
Elizabeth Cooper: Naval Medical Research Command, Silver Spring, MD, USA
Lindsey White: Naval Medical Research Command, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
David Wallace: Naval Medical Research Command, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
Silvia Jakubski: Naval Medical Research Command, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
David Boulifard: Naval Medical Research Command, Silver Spring, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
Megan Schilling: Naval Medical Research Command, Silver Spring, MD, USA
Peifang Sun: Naval Medical Research Command, Silver Spring, MD, USA
Jan Marayag: Naval Medical Research Command, Silver Spring, MD, USA
Amethyst Marrone: Naval Medical Research Command, Silver Spring, MD, USA
Edgar O. Nunez-Hernandez: Naval Medical Research Command, Silver Spring, MD, USA
Sindhu Vangeti: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
Clare Miller: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Yongchao Ge: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Irene Ramos: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Carl Goforth: Naval Medical Research Command, Silver Spring, MD, USA
Stuart C. Sealfon: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Andrew G. Letizia: Naval Medical Research Command, Silver Spring, MD, USA; Corresponding author. Naval Medical Research Unit INDO PACIFIC, 285 Sudan Rd, Singapore, 757965.

Journal volume & issue: Vol. 39
p. 100909

Abstract

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Summary: Background: Long-term SARS-CoV-2 adverse health outcomes are of significant concern, especially among young adults with the potential for the greatest long-term morbidity. We sought to assess and characterize these outcomes in a cohort of Marines. Methods: We used a cohort of US Marines from a previous longitudinal, prospective observational study of acute SARS-CoV-2, most of whom were enrolled prior to infection. A panel study was established to assess for post-acute sequelae of COVID-19 (PASC), defined as symptoms at least 4 weeks after symptom onset or diagnosis. Symptoms were assessed through questionnaires and validated quality of health metrics. Periodic US Marine Corps fitness testing metrics provided an additional standardized functional assessment and were compared to a pre-pandemic cohort. Findings: Globally dispersed Marine participants (n = 899) seen an average of 330 days following initial enrollment were predominately male (n = 825, 91.7%), White (n = 613, 71.6%) or Black (n = 149, 17.4%) with a median age of 18 years (interquartile range: 18–19). Among 798 SARS-CoV-2 infected participants, 197 (24.7%) developed PASC. The most prevalent symptoms were loss of taste and/or smell (n = 82; 41.6%), shortness of breath (n = 74; 37.6%), and cough (n = 45; 22.8%). Those with PASC had higher rates and severity of somatic (p < 0.0001), general depressive (p < 0.0001), and anxiety (p = 0.005) symptoms. Compared to a historic cohort of Marines, participants with PASC scored worse on their physical fitness assessments due to slower run times (p = 0.002). Those with PASC continued to have decreased physical performance one year after completing initial training. Interpretation: In this population of healthy young adult US Marines with mostly either asymptomatic or mild acute COVID-19, one fourth reported physical, cognitive, or psychiatric long-term sequelae of infection. The Marines affected with PASC showed evidence of long-term decrease in functional performance suggesting that SARS-CoV-2 infection may negatively affect health for a significant proportion of young adults. Funding: Defense Health Agency and Defense Advanced Research Projects Agency.

Published in The Lancet Regional Health. Americas

ISSN: 2667-193X (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.thelancet.com/journals/lanam/home

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