Study: Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study. Image Credit: Donkeyworx / Shutterstock

The largest study to date on the long-term impact of vaccination on COVID

In a recent study published in British Medical JournalResearchers evaluated the relationship between vaccination against coronavirus disease 2019 (COVID-19) and prolonged COVID symptoms among adults residing in United Kingdom (UK) communities with a positive history of COVID-19 prior to vaccination.

COVID-19 vaccines have been effective in reducing SARS-CoV-2 infection, transmission, hospitalization, and mortality. The likelihood of prolonged COVID infection may be lower among individuals infected with SARS-CoV-2 after vaccination; However, the relationship between the COVID-19 vaccine and prolonged COVID symptoms is unclear.

Study: Prolonged course of COVID-19 symptoms after COVID-19 vaccination: a community cohort study. Image Credit: Donkeyworx / Shutterstock

about studying

In the current community-based observational cohort study, researchers evaluated the likelihood of exposure to prolonged COVID symptoms and the effect of prolonged COVID on performance of daily activities among a British community population with SARS-CoV-2 infection prior to COVID-19 vaccination.

Study participant flow chart.

Study participant flow chart. CIS = Office for National Statistics COVID-19 Infection Survey

The study included individuals between the ages of 18 and 69 who participated in the COVID-19 infection survey, which included households in the UK (excluding community institutions such as nursing homes, hospitals, nursing homes, prisons and residence halls). Vaccination data (vaccine doses, vaccination history and vaccine manufacturers) were obtained from the COVID-19 Infection Survey and the National Immunization Management System for participants residing in England.

At each monthly follow-up visit, participants were asked if they had experienced any symptoms of prolonged COVID (defined as symptoms that have persisted for at least four weeks after COVID-19 was suspected or confirmed that cannot be explained by any other health condition). Survey participants also submitted self-collected oropharyngeal and oropharyngeal swab samples for reverse transcription-polymerase chain reaction (RT-PCR) testing at each follow-up visit.

The primary outcome measure was the presence of prolonged COVID symptoms for at least 12 weeks after infection with SARS-CoV-2 and during follow-up between 3 February and 5 September 2021. The secondary outcome measure was limitations in performing daily activities due to prolonged COVID. In addition, the team evaluated 10 symptoms most frequently reported during follow-up and whether participants experienced >3 or >5 of the 21 prolonged COVID symptoms included in the survey.

All participants were vaccinated with either a single dose of the COVID-19 adenovirus vector vaccine (ChAdOx1 nCoV-19) or the messenger ribonucleic acid (mRNA) vaccine (BNT162b2 or mRNA-1273) after a positive SARS-CoV-2 test.

Survey questions were asked about prolonged COVID symptoms that persisted for more than 4 weeks after infection with SARS-CoV-2; However, for the analysis, a period of 12 weeks was used, as per the World Health Organization (WHO) definition of post-COVID-19 case and the UK clinical case definition of post-COVID-19 syndrome.

consequences

Of the 28,356 study participants, the mean age was 46 years and 56% (n = 15,760) were female. The majority of participants (89%) were white. Median follow-up periods were 141 days and 67 days after the first and second COVID-19 vaccinations, respectively.

Typical odds of COVID-19 for a hypothetical study participant who received an initial dose of COVID-19 vaccine 24 weeks after exposure to SARS and a second dose 12 weeks later.  Probabilities are shown for participants of mean age (50 years) and in the cohort cohort of other covariates (woman, white race, London resident, resident of an area in the fifth least deprived group, not a patient-faced health or social worker, no cases A former healthy person, who was not hospitalized during the acute phase of infection, was infected on September 7, 2020).  Although the estimated probabilities are specific to this profile, the relative changes in probabilities after vaccination do not differ for different characteristics, and thus can be generalized to other profiles.  The dashed lines represent the timing of vaccination.  Shaded areas are 95% confidence intervals

Typical odds of COVID-19 for a hypothetical study participant who received an initial dose of COVID-19 vaccine 24 weeks after exposure to SARS and a second dose 12 weeks later. Probabilities are shown for participants of mean age (50 years) and in the cohort cohort of other covariates (woman, white race, London resident, resident of an area in the fifth least deprived group, not a patient-faced health or social worker, no cases A former healthy person, who was not hospitalized during the acute phase of infection, was infected on September 7, 2020). Although the estimated probabilities are specific to this profile, the relative changes in probabilities after vaccination do not differ for different characteristics, and thus can be generalized to other profiles. The dashed lines represent the timing of vaccination. Shaded areas are 95% confidence intervals

A total of 6,729 participants (24%) experienced prolonged COVID symptoms at least once during the follow-up period. After the first vaccination, a 13% decrease in the likelihood of long COVID symptoms was observed, followed by elevations and decreases in the long course of COVID symptoms (ranging from 0.3% to 1.2% per week). After the second vaccination, an initial 9% reduction in the likelihood of prolonged COVID symptoms was observed, followed by further reductions of 0.8% weekly.

Modeled probabilities of individual COVID-19 symptoms for a hypothetical study participant who received the first dose of COVID-19 vaccine 24 weeks after SARS infection and a second dose 12 weeks later.  The 10 most commonly reported symptoms are arranged in order of typical likelihood at 12 weeks after infection.  Probabilities are shown for a participant of average age (50 years) and in the cohort cohort of other covariates (woman, white race, London resident, resident in an area in the fifth least deprived group, not healthy or socially unhealthy or socially encountered patient care worker, no health conditions Previously, he was not hospitalized during the acute phase of infection, was infected on September 7, 2020).  Although the estimated probabilities are specific to this profile, the relative changes in probabilities after vaccination do not differ for different characteristics, and thus can be generalized to other profiles.  The dashed lines represent the timing of vaccination.  Shaded areas are 95% confidence intervalsModeled probabilities of individual COVID-19 symptoms for a hypothetical study participant who received the first dose of COVID-19 vaccine 24 weeks after SARS infection and a second dose 12 weeks later. The 10 most commonly reported symptoms are arranged in order of typical likelihood at 12 weeks after infection. Probabilities are shown for a participant of average age (50 years) and in the cohort cohort of other covariates (woman, white race, London resident, resident in an area in the fifth least deprived group, not healthy or social patient encountering a care worker, no health conditions Previously, he was not hospitalized during the acute phase of infection, was infected on September 7, 2020). Although the estimated probabilities are specific to this profile, the relative changes in probabilities after vaccination do not differ for different characteristics, and thus can be generalized to other profiles. The dashed lines represent the timing of vaccination. Shaded areas are 95% confidence intervals

Prolonged COVID symptoms leading to restriction of daily activities were reported by 4,747 participants (17%) at least once during the follow-up period. The first vaccination was associated with an initial 12% decrease in the probability of limiting daily activity followed by an uncertain course (0.9% weekly) until the second vaccination. The second vaccination was associated with an initial 9% decrease in the likelihood of limiting daily activity, followed by -0.5% weekly until the end of the follow-up period.

No significant differences were found in the association between COVID-19 vaccines and prolonged COVID symptoms by health-related factors, sociodemographic characteristics, hospitalization with severe SARS-CoV-2 infection, type of vaccination (mRNA vaccine or adenovirus vector vaccine), or The time between COVID-19 and its vaccination.

The odds of experiencing >3 or >5 symptoms of COVID-19 initially decreased after the first and second vaccinations. After the first vaccination, the greatest reductions in olfactory loss (13%), age (9%), and poor sleep (9%) were observed. After the second vaccination, the most significant decreases in fatigue (10%), headache (9%) and poor sleep (9%) were noted.

Overall, the study results showed that the odds of developing prolonged COVID symptoms were reduced after vaccination against SARS-CoV-2, with immunity still maintained after the second vaccination, at least during the 67-day follow-up period. The findings underscore the importance of vaccination to reduce the healthcare burden of the coronavirus. However, more research is needed with longer follow-up periods.

Journal reference:

  • Daniel Ayoubkhani, Charlotte Birmingham, Queen B Boyles, Meyer Glickman, Fahi Navelian, Francesco Zaccardi, Kamlesh Khonte, Nasrin Alwan, Sarah Walker. Prolonged course of COVID-19 disease symptoms after COVID-19 vaccination: a community cohort study, BMJ2022; 377: e069676. DOI: 10.1136/bmj-2021-069676, https://www.bmj.com/content/377/bmj-2021-069676

2022-05-23 04:45:00

Leave a Comment

Your email address will not be published.