PMID- 37352144 OWN - NLM STAT- MEDLINE DCOM- 20230626 LR - 20230929 IS - 2047-2986 (Electronic) IS - 2047-2978 (Print) IS - 2047-2978 (Linking) VI - 13 DP - 2023 Jun 23 TI - Post-COVID symptom profiles and duration in a global convalescent COVID-19 observational cohort: Correlations with demographics, medical history, acute COVID-19 severity and global region. PG - 06020 LID - 10.7189/jogh.13.06020 [doi] LID - 06020 AB - BACKGROUND: Post-COVID conditions are characterised by persistent symptoms that negatively impact quality of life after SARS-CoV-2 diagnosis. While post-COVID risk factors and symptoms have been extensively described in localised regions, especially in the global north, post-COVID conditions remain poorly understood globally. The global, observational cohort study HVTN 405/HPTN 1901 characterises the convalescent course of SARS-CoV-2 infection among adults in North and South America and Africa. METHODS: We categorised the cohort by infection severity (asymptomatic, symptomatic, no oxygen requirement (NOR), non-invasive oxygen requirement (NIOR), invasive oxygen requirement (IOR)). We applied a regression model to assess correlations of demographics, co-morbidities, disease severity, and concomitant medications with COVID-19 symptom persistence and duration across global regions. RESULTS: We enrolled 759 participants from Botswana, Malawi, South Africa, Zambia, Zimbabwe, Peru, and the USA a median of 51 (interquartile range (IQR) = 35-66) days post-diagnosis, from May 2020 to March 2021. 53.8% were female, 69.8% were 18-55 years old (median (md) = 44 years old, IQR = 33-58). Comorbidities included obesity (42.8%), hypertension (24%), diabetes (14%), human immunodeficiency virus (HIV) infection (11.6%) and lung disease (7.5%). 76.2% were symptomatic (NOR = 47.4%; NIOR = 22.9%; IOR = 5.8%). Median COVID-19 duration among symptomatic participants was 20 days (IQR = 11-35); 43.4% reported symptoms after COVID-19 resolution, 33.6% reported symptoms >/=30 days, 9.9% reported symptoms >/=60 days. Symptom duration correlated with disease severity (P < 0.001, NIOR vs NOR; P = 0.003, IOR vs NOR), lung disease (P = 0.001), race (P < 0.05, non-Hispanic Black vs White), and global region (P < 0.001). Prolonged viral shedding correlated with persistent abdominal pain (odds ratio (OR) = 5.51, P < 0.05) and persistent diarrhoea (OR = 6.64, P < 0.01). CONCLUSIONS: Post-COVID duration varied with infection severity, race, lung disease, and region. Better understanding post-COVID conditions, including regionally-diverse symptom profiles, may improve clinical assessment and management globally. REGISTRATION: Clinicaltrials.gov (#NCT04403880). CI - Copyright (c) 2023 by the Journal of Global Health. All rights reserved. FAU - Karuna, Shelly AU - Karuna S AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - Gallardo-Cartagena, Jorge A AU - Gallardo-Cartagena JA AD - Centro de Investigaciones Tecnologicas, Biomedicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Lima, Peru. FAU - Theodore, Deborah AU - Theodore D AD - Columbia University Physicians & Surgeons, New York, New York, USA. FAU - Hunidzarira, Portia AU - Hunidzarira P AD - University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe. FAU - Montenegro-Idrogo, Juan AU - Montenegro-Idrogo J AD - Centro de Investigaciones Tecnologicas, Biomedicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Lima, Peru. FAU - Hu, Jiani AU - Hu J AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - Jones, Megan AU - Jones M AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - Kim, Vicky AU - Kim V AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - De La Grecca, Robert AU - De La Grecca R AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - Trahey, Meg AU - Trahey M AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - Karg, Carissa AU - Karg C AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - Takalani, Azwi AU - Takalani A AD - Hutchinson Centre for Research in South Africa, Johannesburg, Republic of South Africa. FAU - Polakowski, Laura AU - Polakowski L FAU - Hutter, Julia AU - Hutter J FAU - Miner, Maurine D AU - Miner MD AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - Erdmann, Nathan AU - Erdmann N FAU - Goepfert, Paul AU - Goepfert P FAU - Maboa, Rebone AU - Maboa R AD - Ndlovu Research Centre, Elandsdoorn, Limpopo, Republic of South Africa. FAU - Corey, Lawrence AU - Corey L AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. FAU - Gill, Katherine AU - Gill K AD - Desmond Tutu HIV Foundation, University of Cape Town, Cape Town, Republic of South Africa. FAU - Li, Shuying Sue AU - Li SS AD - Fred Hutchinson Cancer Center, Seattle, Washington, USA. CN - HVTN 405/HPTN 1901 Study Team LA - eng SI - ClinicalTrials.gov/NCT04403880 GR - UM1 AI069423/AI/NIAID NIH HHS/United States GR - U01 AI069470/AI/NIAID NIH HHS/United States GR - UM1 AI069470/AI/NIAID NIH HHS/United States GR - UM1 AI068614/AI/NIAID NIH HHS/United States GR - UM1 AI068635/AI/NIAID NIH HHS/United States GR - UM1 AI068617/AI/NIAID NIH HHS/United States PT - Journal Article PT - Observational Study DEP - 20230623 PL - Scotland TA - J Glob Health JT - Journal of global health JID - 101578780 SB - IM MH - Adult MH - Humans MH - Female MH - Adolescent MH - Young Adult MH - Middle Aged MH - Male MH - *COVID-19/epidemiology MH - SARS-CoV-2 MH - COVID-19 Testing MH - Quality of Life MH - Post-Acute COVID-19 Syndrome MH - Botswana PMC - PMC10289480 COIS- Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare the following activities and relationships: PG reports funding from HVTN, consulting fees from Johnson & Johnson and DSMB activities. The other authors declare no conflicts of interest: KG, CK, JH, LP, MT, PH, RD, JGC, JM, LC, MJ, SL, VK, JH, MDM, SK, DT, NE, AT, RM. EDAT- 2023/06/23 19:11 MHDA- 2023/06/26 06:42 PMCR- 2023/06/23 CRDT- 2023/06/23 13:23 PHST- 2023/06/26 06:42 [medline] PHST- 2023/06/23 19:11 [pubmed] PHST- 2023/06/23 13:23 [entrez] PHST- 2023/06/23 00:00 [pmc-release] AID - jogh-13-06020 [pii] AID - 10.7189/jogh.13.06020 [doi] PST - epublish SO - J Glob Health. 2023 Jun 23;13:06020. doi: 10.7189/jogh.13.06020.