Long Covid after Breakthrough COVID-19: the post-acute sequelae of breakthrough COVID-19
Nature Portfolio Journal. DOI: 10.21203/rs.3.rs-1062160/v1 preprint
69 tweets as of Nov 23
Ziyad Al-Aly, Benjamin Bowe, Yan Xie
Risk details: long-haul vs no COVID
Risk Summary: long-haul vs no COVID
Risk: not Hospitalized vs Hospitalized (All or just vaxed?)
Less Long-haul problems if vaccinated
The post-acute sequelae of COVID-19 have been described1, but whether breakthrough COVID-19 (that is the disease that ensues following vaccine breakthrough SARS-CoV-2 infection) results in post-acute sequelae is not yet clear.
Here we use the national healthcare databases of the US Department of Veterans Affairs to characterize 6-month risks of incident post-acute sequelae in people with breakthrough COVID-19 who survived for at least 30 days after diagnosis.
We show that compared to people with no evidence of COVID-19, beyond the first 30 days of illness, people with breakthrough COVID-19 exhibit a higher risk of death and broad array of incident post-acute sequelae in the
- pulmonary system, as well as extrapulmonary sequelae that include
- cardiovascular disorders,
- coagulation disorders,
- gastrointestinal disorders,
- general disorders (e.g., fatigue),
- kidney disorders,
- mental health disorders,
- metabolic disorders,
- musculoskeletal disorders, and
- neurologic disorders.
Our analyses by care setting of the acute phase of the disease show that people who were not hospitalized during the first 30 days after diagnosis with breakthrough COVID-19 exhibit a small but not insignificant increase in risk of death and post-acute sequelae; the risks are further increased in people who were hospitalized during the acute phase of the disease. Our comparative approach shows that people with breakthrough COVID-19 exhibit lower risks of death and post-acute sequelae than people with COVID-19 who were not previously vaccinated for it; and in analyses among individuals who were hospitalized during the acute phase of the disease, people with breakthrough COVID-19 exhibit higher risks of death and post-acute sequelae than people with seasonal influenza. Altogether, our findings show increased risks of death and post-acute sequalae in people with breakthrough COVID-19; the risks are evident among those who were not hospitalized during the acute phase of the disease. Our comparative approach provides context for understanding the risks in relation to COVID-19 without prior vaccination and seasonal influenza. The findings will inform the ongoing effort to optimize strategies for prevention of breakthrough SARS-CoV-2 infections and will guide development and optimization of post-acute care pathways for people with breakthrough COVID-19.
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Study was reviewed at MDEdge
- "Researchers analyzed data collected by the U.S. Veterans Affairs from 16,035 survivors of breakthrough infections, 48,536 unvaccinated COVID-19 survivors, and nearly 3.6 million uninfected people."
- "At six months after infection, after taking their risk factors into account, people with breakthrough infections had lower rates of death and long-term lingering health problems than COVID-19 patients who had not been vaccinated. But compared to people who never had COVID-19, those who had breakthrough infections had a 53% higher risk of death and a 59% higher risk of having at least one new medical condition, particularly problems affecting the lungs and other organs."