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Article ; Online: SARS-CoV-2 infection is associated with self-reported post-acute neuropsychological symptoms within six months of follow-up.

Andronescu, Liana R / Richard, Stephanie A / Scher, Ann I / Lindholm, David A / Mende, Katrin / Ganesan, Anuradha / Huprikar, Nikhil / Lalani, Tahaniyat / Smith, Alfred / Mody, Rupal M / Jones, Milissa U / Bazan, Samantha E / Colombo, Rhonda E / Colombo, Christopher J / Ewers, Evan / Larson, Derek T / Maves, Ryan C / Berjohn, Catherine M / Maldonado, Carlos J /

English, Caroline / Sanchez Edwards, Margaret / Rozman, Julia S / Rusiecki, Jennifer / Byrne, Celia / Simons, Mark P / Tribble, David / Burgess, Timothy H / Pollett, Simon D / Agan, Brian K

PloS one

2024 Volume 19, Issue 4, Page(s) e0297481

Abstract: Background: Chronic neuropsychological sequelae following SARS-CoV-2 infection, including depression, anxiety, fatigue, and general cognitive difficulties, are a major public health concern. Given the potential impact of long-term neuropsychological ... ...

Abstract	Background: Chronic neuropsychological sequelae following SARS-CoV-2 infection, including depression, anxiety, fatigue, and general cognitive difficulties, are a major public health concern. Given the potential impact of long-term neuropsychological impairment, it is important to characterize the frequency and predictors of this post-infection phenotype. Methods: The Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases with Pandemic Potential (EPICC) study is a longitudinal study assessing the impact of SARS-CoV-2 infection in U.S. Military Healthcare System (MHS) beneficiaries, i.e. those eligible for care in the MHS including active duty servicemembers, dependents, and retirees. Four broad areas of neuropsychological symptoms were assessed cross-sectionally among subjects 1-6 months post-infection/enrollment, including: depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), fatigue (PROMIS® Fatigue 7a), and cognitive function (PROMIS® Cognitive Function 8a and PROMIS® Cognitive Function abilities 8a). Multivariable Poisson regression models compared participants with and without SARS-CoV-2 infection history on these measures, adjusting for sex, ethnicity, active-duty status, age, and months post-first positive or enrollment of questionnaire completion (MPFP/E); models for fatigue and cognitive function were also adjusted for depression and anxiety scores. Results: The study population included 2383 participants who completed all five instruments within six MPFP/E, of whom 687 (28.8%) had at least one positive SARS-CoV-2 test. Compared to those who had never tested positive for SARS-CoV-2, the positive group was more likely to meet instrument-based criteria for depression (15.4% vs 10.3%, p<0.001), fatigue (20.1% vs 8.0%, p<0.001), impaired cognitive function (15.7% vs 8.6%, p<0.001), and impaired cognitive function abilities (24.3% vs 16.3%, p<0.001). In multivariable models, SARS-CoV-2 positive participants, assessed at an average of 2.7 months after infection, had increased risk of moderate to severe depression (RR: 1.44, 95% CI 1.12-1.84), fatigue (RR: 2.07, 95% CI 1.62-2.65), impaired cognitive function (RR: 1.64, 95% CI 1.27-2.11), and impaired cognitive function abilities (RR: 1.41, 95% CI 1.15-1.71); MPFP/E was not significant. Conclusions: Participants with a history of SARS-CoV-2 infection were up to twice as likely to report cognitive impairment and fatigue as the group without prior SARS-CoV-2 infection. These findings underscore the continued importance of preventing SARS-CoV-2 infection and while time since infection/enrollment was not significant through 6 months of follow-up, this highlights the need for additional research into the long-term impacts of COVID-19 to mitigate and reverse these neuropsychological outcomes.
MeSH term(s)	Humans ; Self Report ; COVID-19/complications ; COVID-19/epidemiology ; SARS-CoV-2 ; Follow-Up Studies ; Longitudinal Studies ; Fatigue/epidemiology ; Fatigue/etiology ; Anxiety Disorders
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0297481
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Article ; Online: A machine learning approach identifies distinct early-symptom cluster phenotypes which correlate with hospitalization, failure to return to activities, and prolonged COVID-19 symptoms.

Epsi, Nusrat J / Powers, John H / Lindholm, David A / Mende, Katrin / Malloy, Allison / Ganesan, Anuradha / Huprikar, Nikhil / Lalani, Tahaniyat / Smith, Alfred / Mody, Rupal M / Jones, Milissa U / Bazan, Samantha E / Colombo, Rhonda E / Colombo, Christopher J / Ewers, Evan C / Larson, Derek T / Berjohn, Catherine M / Maldonado, Carlos J / Blair, Paul W /

Chenoweth, Josh / Saunders, David L / Livezey, Jeffrey / Maves, Ryan C / Sanchez Edwards, Margaret / Rozman, Julia S / Simons, Mark P / Tribble, David R / Agan, Brian K / Burgess, Timothy H / Pollett, Simon D

PloS one

2023 Volume 18, Issue 2, Page(s) e0281272

Abstract: Background: Accurate COVID-19 prognosis is a critical aspect of acute and long-term clinical management. We identified discrete clusters of early stage-symptoms which may delineate groups with distinct disease severity phenotypes, including risk of ... ...

Abstract	Background: Accurate COVID-19 prognosis is a critical aspect of acute and long-term clinical management. We identified discrete clusters of early stage-symptoms which may delineate groups with distinct disease severity phenotypes, including risk of developing long-term symptoms and associated inflammatory profiles. Methods: 1,273 SARS-CoV-2 positive U.S. Military Health System beneficiaries with quantitative symptom scores (FLU-PRO Plus) were included in this analysis. We employed machine-learning approaches to identify symptom clusters and compared risk of hospitalization, long-term symptoms, as well as peak CRP and IL-6 concentrations. Results: We identified three distinct clusters of participants based on their FLU-PRO Plus symptoms: cluster 1 ("Nasal cluster") is highly correlated with reporting runny/stuffy nose and sneezing, cluster 2 ("Sensory cluster") is highly correlated with loss of smell or taste, and cluster 3 ("Respiratory/Systemic cluster") is highly correlated with the respiratory (cough, trouble breathing, among others) and systemic (body aches, chills, among others) domain symptoms. Participants in the Respiratory/Systemic cluster were twice as likely as those in the Nasal cluster to have been hospitalized, and 1.5 times as likely to report that they had not returned-to-activities, which remained significant after controlling for confounding covariates (P < 0.01). Respiratory/Systemic and Sensory clusters were more likely to have symptoms at six-months post-symptom-onset (P = 0.03). We observed higher peak CRP and IL-6 in the Respiratory/Systemic cluster (P < 0.01). Conclusions: We identified early symptom profiles potentially associated with hospitalization, return-to-activities, long-term symptoms, and inflammatory profiles. These findings may assist in patient prognosis, including prediction of long COVID risk.
MeSH term(s)	Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Interleukin-6 ; Phenotype ; Hospitalization ; Machine Learning
Chemical Substances	Interleukin-6
Language	English
Publishing date	2023-02-09
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0281272
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Article: Decreased Self-reported Physical Fitness Following SARS-CoV-2 Infection and the Impact of Vaccine Boosters in a Cohort Study.

Richard, Stephanie A / Scher, Ann I / Rusiecki, Jennifer / Byrne, Celia / Berjohn, Catherine M / Fries, Anthony C / Lalani, Tahaniyat / Smith, Alfred G / Mody, Rupal M / Ganesan, Anuradha / Huprikar, Nikhil / Colombo, Rhonda E / Colombo, Christopher J / Schofield, Christina / Lindholm, David A / Mende, Katrin / Morris, Michael J / Jones, Milissa U / Flanagan, Ryan /

Larson, Derek T / Ewers, Evan C / Bazan, Samantha E / Saunders, David / Maves, Ryan C / Livezey, Jeffrey / Maldonado, Carlos J / Edwards, Margaret Sanchez / Rozman, Julia S / O'Connell, Robert J / Simons, Mark P / Tribble, David R / Agan, Brian K / Burgess, Timothy H / Pollett, Simon D

Open forum infectious diseases

2023 Volume 10, Issue 12, Page(s) ofad579

Abstract: Background: The long-term effects of coronavirus disease 2019 (COVID-19) on physical fitness are unclear, and the impact of vaccination on that relationship is uncertain.: Methods: We compared survey responses in a 1-year study of US military service ...

Abstract	Background: The long-term effects of coronavirus disease 2019 (COVID-19) on physical fitness are unclear, and the impact of vaccination on that relationship is uncertain. Methods: We compared survey responses in a 1-year study of US military service members with (n = 1923) and without (n = 1591) a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We fit Poisson regression models to estimate the association between history of SARS-CoV-2 infection and fitness impairment, adjusting for time since infection, demographics, and baseline health. Results: The participants in this analysis were primarily young adults aged 18-39 years (75%), and 71.5% were male. Participants with a history of SARS-CoV-2 infection were more likely to report difficulty exercising (38.7% vs 18.4%; Conclusions: In this study of generally young, healthy military service members, SARS-CoV-2 infection was associated with lower self-reported fitness and exercise capacity; vaccination and boosting were associated with lower risk of self-reported fitness loss.
Language	English
Publishing date	2023-11-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofad579
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Article ; Online: Persistent COVID-19 Symptoms at 6 Months After Onset and the Role of Vaccination Before or After SARS-CoV-2 Infection.

Richard, Stephanie A / Pollett, Simon D / Fries, Anthony C / Berjohn, Catherine M / Maves, Ryan C / Lalani, Tahaniyat / Smith, Alfred G / Mody, Rupal M / Ganesan, Anuradha / Colombo, Rhonda E / Lindholm, David A / Morris, Michael J / Huprikar, Nikhil / Colombo, Christopher J / Madar, Cristian / Jones, Milissa / Larson, Derek T / Bazan, Samantha E / Mende, Katrin /

Saunders, David / Livezey, Jeffrey / Lanteri, Charlotte A / Scher, Ann I / Byrne, Celia / Rusiecki, Jennifer / Ewers, Evan / Epsi, Nusrat J / Rozman, Julia S / English, Caroline / Simons, Mark P / Tribble, David R / Agan, Brian K / Burgess, Timothy H

JAMA network open

2023 Volume 6, Issue 1, Page(s) e2251360

Abstract: Importance: Understanding the factors associated with post-COVID conditions is important for prevention.: Objective: To identify characteristics associated with persistent post-COVID-19 symptoms and to describe post-COVID-19 medical encounters.: ... ...

Abstract	Importance: Understanding the factors associated with post-COVID conditions is important for prevention. Objective: To identify characteristics associated with persistent post-COVID-19 symptoms and to describe post-COVID-19 medical encounters. Design, setting, and participants: This cohort study used data from the Epidemiology, Immunology, and Clinical Characteristics of Emerging Infectious Diseases With Pandemic Potential (EPICC) study implemented in the US military health system (MHS); MHS beneficiaries aged 18 years or older who tested positive for SARS-CoV-2 from February 28, 2020, through December 31, 2021, were analyzed, with 1-year follow-up. Exposures: SARS-CoV-2 infection. Main outcomes and measures: The outcomes analyzed included survey-reported symptoms through 6 months after SARS-CoV-2 infection and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis categories reported in medical records 6 months following SARS-CoV-2 infection vs 3 months before infection. Results: More than half of the 1832 participants in these analyses were aged 18 to 44 years (1226 [66.9%]; mean [SD] age, 40.5 [13.7] years), were male (1118 [61.0%]), were unvaccinated at the time of their infection (1413 [77.1%]), and had no comorbidities (1290 [70.4%]). A total of 728 participants (39.7%) had illness that lasted 28 days or longer (28-89 days: 364 [19.9%]; ≥90 days: 364 [19.9%]). Participants who were unvaccinated prior to infection (risk ratio [RR], 1.39; 95% CI, 1.04-1.85), reported moderate (RR, 1.80; 95% CI, 1.47-2.22) or severe (RR, 2.25; 95% CI, 1.80-2.81) initial illnesses, had more hospitalized days (RR per each day of hospitalization, 1.02; 95% CI, 1.00-1.03), and had a Charlson Comorbidity Index score of 5 or greater (RR, 1.55; 95% CI, 1.01-2.37) were more likely to report 28 or more days of symptoms. Among unvaccinated participants, postinfection vaccination was associated with a 41% lower risk of reporting symptoms at 6 months (RR, 0.59; 95% CI, 0.40-0.89). Participants had higher risk of pulmonary (RR, 2.00; 95% CI, 1.40-2.84), diabetes (RR, 1.46; 95% CI, 1.00-2.13), neurological (RR, 1.29; 95% CI, 1.02-1.64), and mental health-related medical encounters (RR, 1.28; 95% CI, 1.01-1.62) at 6 months after symptom onset than at baseline (before SARS-CoV-2 infection). Conclusions and relevance: In this cohort study, more severe acute illness, a higher Charlson Comorbidity Index score, and being unvaccinated were associated with a higher risk of reporting COVID-19 symptoms lasting 28 days or more. Participants with COVID-19 were more likely to seek medical care for diabetes, pulmonary, neurological, and mental health-related illness for at least 6 months after onset compared with their pre-COVID baseline health care use patterns. These findings may inform the risk-benefit ratio of COVID-19 vaccination policy.
MeSH term(s)	Humans ; Male ; Adult ; Female ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; COVID-19 Vaccines ; Cohort Studies ; Post-Acute COVID-19 Syndrome
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-01-03
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.51360
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Article ; Online: Chronic Opioid Prescribing in Primary Care: Factors and Perspectives.

Tong, Sebastian T / Hochheimer, Camille J / Brooks, E Marshall / Sabo, Roy T / Jiang, Vivian / Day, Teresa / Rozman, Julia S / Kashiri, Paulette Lail / Krist, Alex H

Annals of family medicine

2019 Volume 17, Issue 3, Page(s) 200–206

Abstract: Background: Primary care clinicians write 45% of all opioid prescriptions in the United States, but little is known about the characteristics of patients who receive them and the clinicians who prescribe opioids in primary care settings. Our study aimed ...

Abstract	Background: Primary care clinicians write 45% of all opioid prescriptions in the United States, but little is known about the characteristics of patients who receive them and the clinicians who prescribe opioids in primary care settings. Our study aimed to describe the patient and clinician characteristics and clinicians' perspectives of chronic opioid prescribing in primary care. Methods: Using a mixed methods approach, we completed an analysis of 2016 electronic health records from 21 primary care practices to identify patients who had received chronic opioids, which we defined as in receipt of an opioid prescription for at least 3 consecutive months. We compared those receiving chronic opioids with those not in terms of their demographics, prescribing clinician characteristics, and risk factors for opioid-related harms, as identified by the Centers for Disease Control and Prevention Guideline on Opioid Prescribing for Chronic Pain. We then interviewed 16 primary care clinicians about their perspectives on chronic opioid prescribing. Results: Of 84,029 patients, 1.1% (902/84,929) received chronic opioid prescriptions. Characteristics associated with being prescribed chronic opioids include being female, being of black or African American race, and having risks for opioid-related harms, such as mental health diagnoses, substance use disorder, and concurrent benzodiazepine use. Clinicians report multiple difficulties in weaning patients from chronic opioids, including medical contraindications of nonopioid alternatives and difficulty justifying weaning by stable long-term patients. Conclusion: Although patients prescribed opioids in primary care have higher risks of opioid-related harms, clinicians report multiple barriers in deprescribing chronic opioids. Future studies should examine strategies to mitigate these harms and engage patients in shared decision making about their chronic opioid use.
MeSH term(s)	Analgesics, Opioid/administration & dosage ; Attitude of Health Personnel ; Case-Control Studies ; Female ; Humans ; Male ; Practice Patterns, Physicians'/statistics & numerical data ; Primary Health Care/statistics & numerical data ; Qualitative Research ; Risk Factors ; United States
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2019-05-13
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2171425-3
ISSN	1544-1717 ; 1544-1709
ISSN (online)	1544-1717
ISSN	1544-1709
DOI	10.1370/afm.2357
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Article: COVID-19 Patient-Reported Symptoms Using FLU-PRO Plus in a Cohort Study: Associations With Infecting Genotype, Vaccine History, and Return to Health.

Richard, Stephanie A / Epsi, Nusrat J / Lindholm, David A / Malloy, Allison M W / Maves, Ryan C / Berjohn, Catherine M / Lalani, Tahaniyat / Smith, Alfred G / Mody, Rupal M / Ganesan, Anuradha / Huprikar, Nikhil / Colombo, Rhonda E / Colombo, Christopher J / Madar, Cristian / Jones, Milissa U / Larson, Derek T / Ewers, Evan C / Bazan, Samantha / Fries, Anthony C /

Maldonado, Carlos J / Simons, Mark P / Rozman, Julia S / Andronescu, Liana / Mende, Katrin / Tribble, David R / Agan, Brian K / Burgess, Timothy H / Pollett, Simon D / Powers, John H

Open forum infectious diseases

2022 Volume 9, Issue 7, Page(s) ofac275

Abstract: Background: Patient-reported outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are an important measure of the full burden of coronavirus disease (COVID). Here, we examine how (1) infecting genotype and COVID-19 ... ...

Abstract	Background: Patient-reported outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are an important measure of the full burden of coronavirus disease (COVID). Here, we examine how (1) infecting genotype and COVID-19 vaccination correlate with inFLUenza Patient-Reported Outcome (FLU-PRO) Plus score, including by symptom domains, and (2) FLU-PRO Plus scores predict return to usual activities and health. Methods: The Results: Among the 764 participants included in this analysis, 63% were 18-44 years old, 40% were female, and 51% were White. Being fully vaccinated was associated with lower total scores (β = -0.39; 95% CI, -0.57 to -0.21). The Delta variant was associated with higher total scores (β = 0.25; 95% CI, 0.05 to 0.45). Participants with higher FLU-PRO Plus scores were less likely to report returning to usual health and activities (health: hazard ratio [HR], 0.46; 95% CI, 0.37 to 0.57; activities: HR, 0.56; 95% CI, 0.47 to 0.67). Fully vaccinated participants were more likely to report returning to usual activities (HR, 1.24; 95% CI, 1.04 to 1.48). Conclusions: Full SARS-CoV-2 vaccination is associated with decreased severity of patient-reported symptoms across multiple domains, which in turn is likely to be associated with earlier return to usual activities. In addition, infection with the Delta variant was associated with higher FLU-PRO Plus scores than previous variants, even after controlling for vaccination status.
Language	English
Publishing date	2022-06-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofac275
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Article: An Analysis of SARS-CoV-2 Vaccine Reactogenicity: Variation by Type, Dose, and History, Severity, and Recency of Prior SARS-CoV-2 Infection.

Scher, Ann I / Berjohn, Catherine M / Byrne, Celia / Colombo, Rhonda E / Colombo, Christopher J / Edwards, Margaret Sanchez / Ewers, Evan C / Ganesan, Anuradha / Jones, Milissa / Larson, Derek T / Libraty, Daniel / Lindholm, David A / Madar, Cristian S / Maldonado, Carlos J / Maves, Ryan C / Mende, Katrin / Richard, Stephanie A / Rozman, Julia S / Rusiecki, Jennifer /

Smith, Alfred / Simons, Mark / Tribble, David / Agan, Brian / Burgess, Timothy H / Pollett, Simon D

Open forum infectious diseases

2022 Volume 9, Issue 7, Page(s) ofac314

Abstract: Background: There is limited information on the functional consequences of coronavirus disease 2019 (COVID-19) vaccine side effects. To support patient counseling and public health messaging, we describe the risk and correlates of COVID-19 vaccine side ... ...

Abstract	Background: There is limited information on the functional consequences of coronavirus disease 2019 (COVID-19) vaccine side effects. To support patient counseling and public health messaging, we describe the risk and correlates of COVID-19 vaccine side effects sufficient to prevent work or usual activities and/or lead to medical care ("severe" side effects). Methods: The EPICC study is a longitudinal cohort study of Military Healthcare System beneficiaries including active duty service members, dependents, and retirees. We studied 2789 adults who were vaccinated between December 2020 and December 2021. Results: Severe side effects were most common with the Ad26.COV2.S (Janssen/Johnson and Johnson) vaccine, followed by mRNA-1273 (Moderna) then BNT162b2 (Pfizer/BioNTech). Severe side effects were more common after the second than first dose (11% vs 4%; Conclusions: Vaccine side effects sufficient to prevent usual activities were more common after the second than first dose and varied by vaccine type. First dose side effects were more likely in those with a history of COVID-19-particularly if that prior illness was severe or associated with inpatient care. These findings may assist clinicians and patients by providing a real-world evaluation of the likelihood of experiencing impactful postvaccine symptoms.
Language	English
Publishing date	2022-06-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofac314
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Article: Performance of the inFLUenza Patient-Reported Outcome Plus (FLU-PRO Plus) Instrument in Patients With Coronavirus Disease 2019.

Richard, Stephanie A / Epsi, Nusrat J / Pollett, Simon / Lindholm, David A / Malloy, Allison M W / Maves, Ryan / Utz, Gregory C / Lalani, Tahaniyat / Smith, Alfred G / Mody, Rupal M / Ganesan, Anuradha / Colombo, Rhonda E / Colombo, Christopher J / Chi, Sharon W / Huprikar, Nikhil / Larson, Derek T / Bazan, Samantha / Madar, Cristian / Lanteri, Charlotte /

Rozman, Julia S / English, Caroline / Mende, Katrin / Tribble, David R / Agan, Brian K / Burgess, Timothy H / Powers, John H

Open forum infectious diseases

2021 Volume 8, Issue 12, Page(s) ofab517

Abstract: Background: The inFLUenza Patient-Reported Outcome Plus (FLU-PRO Plus) is a patient-reported outcome data collection instrument assessing symptoms of viral respiratory tract infections across 8 body systems. This study evaluated the measurement ... ...

Abstract	Background: The inFLUenza Patient-Reported Outcome Plus (FLU-PRO Plus) is a patient-reported outcome data collection instrument assessing symptoms of viral respiratory tract infections across 8 body systems. This study evaluated the measurement properties of FLU-PRO Plus in a study enrolling individuals with coronavirus disease 2019 (COVID-19). Methods: Data from a prospective cohort study (EPICC) in US Military Health System beneficiaries evaluated for COVID-19 was utilized. Adults with symptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with FLU-PRO Plus survey information within 1 week of symptom onset were included. Reliability of FLU-PRO Plus was estimated using intraclass correlation coefficient (ICC; 2 days' reproducibility). Known-groups validity was assessed using patient global assessment (PGA) of disease severity. Patient report of return to usual health was used to assess responsiveness (day 1-6/7). Results: Two hundred twenty-six SARS-CoV-2-positive participants were included in the analysis. Reliability among those who reported no change in their symptoms from one day to the next was high for most domains (ICC range, 0.68-0.94 for day 1 to day 2). Construct validity was demonstrated by moderate to high correlation between the PGA rating of disease severity and domain and total scores (eg, total scores correlation: 0.69 [influenza-like illness severity], 0.69 [interference in daily activities], and -0.58 [physical health]). In addition, FLU-PRO Plus demonstrated good known-groups validity, with increasing domain and total scores observed with increasing severity ratings. Conclusions: FLU-PRO Plus performs well in measuring signs and symptoms in SARS-CoV-2 infection with excellent construct validity, known-groups validity, and responsiveness to change. Standardized data collection instruments facilitate meta-analyses, vaccine effectiveness studies, and other COVID-19 research activities.
Language	English
Publishing date	2021-10-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofab517
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Article ; Online: Durability of SARS-CoV-2-Specific T-Cell Responses at 12 Months Postinfection.

Lu, Zhongyan / Laing, Eric D / Pena DaMata, Jarina / Pohida, Katherine / Tso, Marana S / Samuels, Emily C / Epsi, Nusrat J / Dorjbal, Batsukh / Lake, Camille / Richard, Stephanie A / Maves, Ryan C / Lindholm, David A / Rozman, Julia S / English, Caroline / Huprikar, Nikhil / Mende, Katrin / Colombo, Rhonda E / Colombo, Christopher J / Broder, Christopher C /

Ganesan, Anuradha / Lanteri, Charlotte A / Agan, Brian K / Tribble, David / Simons, Mark P / Dalgard, Clifton L / Blair, Paul W / Chenoweth, Josh / Pollett, Simon D / Snow, Andrew L / Burgess, Timothy H / Malloy, Allison M W

The Journal of infectious diseases

2021 Volume 224, Issue 12, Page(s) 2010–2019

Abstract: Background: Characterizing the longevity and quality of cellular immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enhances understanding of coronavirus disease 2019 (COVID-19) immunity that influences clinical outcomes. ... ...

Abstract	Background: Characterizing the longevity and quality of cellular immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enhances understanding of coronavirus disease 2019 (COVID-19) immunity that influences clinical outcomes. Prior studies suggest SARS-CoV-2-specific T cells are present in peripheral blood 10 months after infection. Analysis of the function, durability, and diversity of cellular response long after natural infection, over a range of ages and disease phenotypes, is needed to identify preventative and therapeutic interventions. Methods: We identified participants in our multisite longitudinal, prospective cohort study 12 months after SARS-CoV-2 infection representing a range of disease severity. We investigated function, phenotypes, and frequency of T cells specific for SARS-CoV-2 using intracellular cytokine staining and spectral flow cytometry, and compared magnitude of SARS-CoV-2-specific antibodies. Results: SARS-CoV-2-specific antibodies and T cells were detected 12 months postinfection. Severe acute illness was associated with higher frequencies of SARS-CoV-2-specific CD4 T cells and antibodies at 12 months. In contrast, polyfunctional and cytotoxic T cells responsive to SARS-CoV-2 were identified in participants over a wide spectrum of disease severity. Conclusions: SARS-CoV-2 infection induces polyfunctional memory T cells detectable at 12 months postinfection, with higher frequency noted in those who experienced severe disease.
MeSH term(s)	Adult ; Antibodies, Viral ; Antigens, Viral ; Biomarkers ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/immunology ; COVID-19/virology ; Female ; Humans ; Immunity, Cellular ; Immunologic Memory ; Longitudinal Studies ; Male ; Memory T Cells ; Middle Aged ; Prospective Studies ; SARS-CoV-2/immunology ; Severity of Illness Index ; T-Lymphocyte Subsets/immunology ; T-Lymphocyte Subsets/metabolism ; Time Factors
Chemical Substances	Antibodies, Viral ; Antigens, Viral ; Biomarkers
Language	English
Publishing date	2021-10-20
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	3019-3
ISSN	1537-6613 ; 0022-1899
ISSN (online)	1537-6613
ISSN	0022-1899
DOI	10.1093/infdis/jiab543
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Article ; Online: Antigenic cartography of well-characterized human sera shows SARS-CoV-2 neutralization differences based on infection and vaccination history.

Wang, Wei / Lusvarghi, Sabrina / Subramanian, Rahul / Epsi, Nusrat J / Wang, Richard / Goguet, Emilie / Fries, Anthony C / Echegaray, Fernando / Vassell, Russell / Coggins, Si'Ana A / Richard, Stephanie A / Lindholm, David A / Mende, Katrin / Ewers, Evan C / Larson, Derek T / Colombo, Rhonda E / Colombo, Christopher J / Joseph, Janet O / Rozman, Julia S /

Cell host & microbe

2022 Volume 30, Issue 12, Page(s) 1745–1758.e7

Abstract: The rapid emergence of SARS-CoV-2 variants challenges vaccination strategies. Here, we collected 201 serum samples from persons with a single infection or multiple vaccine exposures, or both. We measured their neutralization titers against 15 natural ... ...

Abstract	The rapid emergence of SARS-CoV-2 variants challenges vaccination strategies. Here, we collected 201 serum samples from persons with a single infection or multiple vaccine exposures, or both. We measured their neutralization titers against 15 natural variants and 7 variants with engineered spike mutations and analyzed antigenic diversity. Antigenic maps of primary infection sera showed that Omicron sublineages BA.2, BA.4/BA.5, and BA.2.12.1 are distinct from BA.1 and more similar to Beta/Gamma/Mu variants. Three mRNA COVID-19 vaccinations increased neutralization of BA.1 more than BA.4/BA.5 or BA.2.12.1. BA.1 post-vaccination infection elicited higher neutralization titers to all variants than three vaccinations alone, although with less neutralization to BA.2.12.1 and BA.4/BA.5. Those with BA.1 infection after two or three vaccinations had similar neutralization titer magnitude and antigenic recognition. Accounting for antigenic differences among variants when interpreting neutralization titers can aid the understanding of complex patterns in humoral immunity that informs the selection of future COVID-19 vaccine strains.
MeSH term(s)	Humans ; COVID-19 Vaccines ; SARS-CoV-2/genetics ; COVID-19/prevention & control ; Vaccination ; Antibodies, Viral ; Antibodies, Neutralizing
Chemical Substances	COVID-19 Vaccines ; Antibodies, Viral ; Antibodies, Neutralizing
Language	English
Publishing date	2022-10-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2278004-X
ISSN	1934-6069 ; 1931-3128
ISSN (online)	1934-6069
ISSN	1931-3128
DOI	10.1016/j.chom.2022.10.012
Database	MEDical Literature Analysis and Retrieval System OnLINE

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